Common use of Coverage of Non-Network Providers Clause in Contracts

Coverage of Non-Network Providers. County agrees that should arrangements be made by County with another physician/provider who is not under contract with CalOptima to provide Covered Services required under this Contract, such arrangements shall require physician/provider to (a) accept County’s fees from CalOptima as full payment for services delivered to CalOptima PACE participants, (b) xxxx services provided through County’s office, unless County has made other billing arrangements with CalOptima, (c) not xxxx CalOptima PACE participants directly, under any circumstances, and (d) cooperate with and participate in CalOptima’s quality assurance and improvement program.

Coverage of Non-Network Providers. County agrees that should arrangements be made by County with another physician/provider who is not under contract with CalOptima to provide Covered Services required under this Contract, such arrangements shall require physician/provider to (a) accept County’s fees from CalOptima as full payment for services delivered to CalOptima PACE participants, (b) xxxx bill services provided through County’s office, unless County has made other billing arrangements with CalOptima, (c) not xxxx bill CalOptima PACE participants directly, under any circumstances, and (d) cooperate with and participate in CalOptima’s quality assurance and improvement program.