Common use of Enrollees in an Inpatient Hospital Setting Clause in Contracts

Enrollees in an Inpatient Hospital Setting. (A) In the event that a new Enrollee is a patient in an inpatient hospital setting on the date the new Enrollee’s name appears on the Contractor Eligibility Transmission, the obligation of the Contractor to provide Covered Services to such person shall commence following discharge (i.e., the financial obligation to pay for the inpatient hospital charges shall be the responsibility of the entity who covered the Enrollee at the time of admission). If an Enrollee is a patient in an inpatient hospital setting on the date that their name appears as terminated for any reason other than eligibility on the Contractor Eligibility Transmission or the Enrollee is otherwise disenrolled under this Contract, the Contractor shall remain financially responsible for such care until discharge.

Enrollees in an Inpatient Hospital Setting. (A) In the event that a new Enrollee is a patient in an inpatient hospital setting on the date the new Enrollee’s name appears on the Contractor Eligibility Transmission, the obligation of the Contractor to provide Covered Services to such person shall commence following discharge (i.e., the financial obligation to pay for the inpatient hospital charges shall be the responsibility of the entity health plan or the Department who covered the Enrollee enrollee at the time of admission). If an Enrollee is a patient in an inpatient hospital setting on the date that their his or her name appears as terminated for any reason other than eligibility on the Contractor Eligibility Transmission or the Enrollee he or she is otherwise disenrolled under this Contract, the Contractor shall remain financially responsible for such care until discharge.