Common use of Enrollee Eligibility Clause in Contracts

Enrollee Eligibility. The continued eligibility of Enrollees to obtain Chiropractic Services shall be in accordance with the pertinent health plan company Benefit Contract. Before providing Chiropractic Services to an Enrollee, Doctor shall verify eligibility in accordance with the applicable Plan Summary. Doctor shall not be entitled to payment from any Payor for services provided to any person who is not an eligible Enrollee at the time such services were delivered. Health plan company retains the right of final verification of eligibility. A health plan company’s verification supersedes any authorization of care, Plan Summary and/or claims payment review made by CCMI.