Financial Responsibility for Continuity of Care Services Sample Clauses

Financial Responsibility for Continuity of Care Services. If a Person is entitled to receive Services from a terminated provider under the preceding Xxxxx- nuity of Care provision, the responsibility of the Person to that provider for Services rendered un- der the Continuity of Care provision shall be no greater than for the same Services rendered by a Participating Dentist in the same geographic area. Conditions of Coverage Enrollment of a Subscriber
Sample 1Sample 2Sample 3See All (17)
AutoNDA by SimpleDocs
Financial Responsibility for Continuity of Care Services. If a Member is entitled to receive Services from a terminated provider under the preceding Continuity of Care provision, the responsibility of the Member to that provider for Services rendered under the Continuity of Care provision shall be no greater than for the same Services rendered by a Preferred Provider in the same geographic area. Dues Monthly Dues are as stated in the Appendix. Blue Shield of California offers a variety of options and methods by which you may pay your Dues. Please call Customer Service at the telephone number indicated on your Identification Card to discuss these options or visit the Blue Shield of California internet site at xxxx://xxx.xxxxxxxxxxxx.xxx. Payments by mail are to be sent to: Blue Shield of California P.O. Box 51827 Los Angeles, CA 90051-6127 Additional Dues may be charged in the event that a State or any other taxing authority imposes upon Blue Shield of Cali- fornia a tax or license fee which is calculated upon base dues or Blue Shield of California's gross receipts or any portion of either. Dues increase according to the Subscriber's age, as described in the Appendix. Dues may also increase from time to time as determined by Blue Shield of California. You will receive 60 days written notice of any changes in the monthly dues for this plan. Plan Changes The benefits of this Plan, including but not limited to Covered Services, Deductible, Copayment, and annual copayment maximum amounts, are subject to change at any time. Blue Shield will provide at least 60 days written notice of any such change. Benefits for Services or supplies furnished after the Effective Date of any change in benefits will be based on the change. There is no vested right to obtain benefits.
Sample 1Sample 2Sample 3See All (13)
Financial Responsibility for Continuity of Care Services. If a Member is entitled to receive Services from a terminated provider under the preceding Continuity of Care provision, the responsibility of the Member to that provider for Services rendered under the Continuity of Care provision shall be no greater than for the same Services rendered by a Participating Dentist in the same geographic area. Pre-certification of Dental Benefits Before any course of treatment expected to cost more than $250 is started, you should obtain Pre-certification of Benefits. Your Dentist should submit the recommended treatment plan and fees together with appropriate diagnostic X-rays to a contracted Dental Plan Administrator. A contracted Dental Plan Administrator will review the dental treatment plan to determine the benefits payable under the plan. The benefit determination for the proposed treatment plan will then be promptly returned to the Dentist. When the treatment is completed, your claim form should be submitted to a contracted Dental Plan Administrator for payment determination. A contracted Dental Plan Administrator will notify you of its determination within 30 days after receipt of the claim. The dental plan provides benefits for covered services at the most cost-effective level of care that is consistent with professionally recognized standards of care. If there are two or more professionally recognized procedures for treatment of a dental condition, this plan will in most cases provide benefits based on the most cost-effective procedure. The benefits provided under this plan are based on these considerations but you and your Dentist make the final decision regarding treatment. Failure to obtain Pre-certification of Benefits may result in a denial of benefits. If the Pre-certification process is not followed, a contracted Dental Plan Administrator will still determine payment by taking into account alternative procedures; services or materials for the dental condition based on professionally recognized standards of dental practice. However, by following the Pre-certification process both you and your Dentist will know in advance which services are covered and the benefits that are payable. The covered dental expense will be limited to the Allowable Amount for the procedure, service or material which meets professionally recognized standards of quality dental care and is the most cost effective as determined by a contracted Dental Plan Administrator. If you and your Dentist decide on a more costly procedure, service or...
Sample 1Sample 2See All (5)

Related to Financial Responsibility for Continuity of Care Services

  • Financial Responsibility You understand that you remain, solely and exclusively responsible for any and all financial risks, including, without limitation, insufficient funds associated with accessing the Service. The Credit Union shall not be liable in any manner for such risk unless Credit Union fails to follow the procedures described in materials for use of the service. You assume exclusive responsibility for the consequences of any instructions you give to the Credit Union, for your failures to access the Service properly in a manner prescribed by the Credit Union, and for your failure to supply accurate input information, including, without limitation, any information contained in an application.

  • Professional Responsibility (Article 8.01 applies to employees covered by an Ontario College under the Regulated Health Professions Act only.)

  • Financial Responsibilities Provider shall, at its sole expense:

  • General Responsibility The Consultant shall, at all times during the Agreement, remain responsible. The Consultant agrees, if requested by the Commissioner of NYSDOT or his or her designee, to present evidence of its continuing legal authority to do business in New York State, integrity, experience, ability, prior performance, and organizational and financial capacity.

  • MUTUAL RESPONSIBILITY 6.2.1 The Contractor shall afford the State and separate contractors reasonable opportunity for the introduction and storage of their materials and equipment and the execution of their work, and shall connect and coordinate his / her Work with the work of the State and separate contractors as required by the Contract Documents.

  • General Responsibilities Issuer hereby engages Distributor to act as exclusive distributor of the shares of each class of the Funds. The Funds subject to this Agreement as of the date hereof are identified on SCHEDULE A, which may be amended from time to time in accordance with Section 11 below. Sales of a Fund's shares shall be made only to investors residing in those states in which such Fund is registered. After effectiveness of each Fund’s registration statement, Distributor will hold itself available to receive, as agent for the Fund, and will receive by mail, telex, telephone, or such other method as may be agreed upon between Distributor and Issuer, orders for the purchase of Fund shares, and will accept or reject such orders on behalf of the Fund in accordance with the provisions of the applicable Fund’s prospectus. Distributor will be available to transmit orders, as promptly as possible after it accepts such orders, to the Fund’s transfer agent for processing at the shares’ net asset value next determined in accordance with the prospectuses.

  • Professional Responsibilities Other activities to support the delivery of the Xxxxxx Xxxxxx Business Plan and Xxxxxx Mission Strategic Plan, as requested by your manager • As an employee, be responsible under the Work Health & Safety Act for the health and safety of all persons they come into contact with, during employment • All hazards and injuries must be reported through the normal process as set out in Xxxxxx Mission’s Work Health, Safety and Rehabilitation Quality Management System and site procedures • Participate in the review and maintenance of industry specific and internal audit processes, as per Xxxxxx Mission’s standard policy and procedures • In relation to Xxxxxx Mission and the Uniting Church in Australia, attend such functions, meetings, seminars, training courses as directed by your supervisor • In relation to Xxxxxx Mission attend worship services as encouraged by your supervisor • Participate on a quarterly basis in Xxxxxx Mission’s Employee contribution and development process • Take responsibility for personal career development and training • Participate in Xxxxxx Mission’s Orientation program, so as to gain an understanding of, and • promote, the application of the EEO, Affirmative Action, Privacy Act, Work Health & Safety Act and other relevant legislation • Administer Xxxxxx Mission’s philosophy of care and other relevant policy documents as appropriate • Demonstrate responsible stewardship of all resources, and willingness to report impropriety in keeping with the values of Xxxxxx Mission • Ensure the reputation and integrity of Xxxxxx Mission is maintained at all times • Maintain confidentiality

  • Contractor’s General Responsibilities The Contractor, regardless of any delegation or subcontract entered by the Contractor, shall be responsible for the following when providing information technology staff augmentation services:

Time is Money Join Law Insider Premium to draft better contracts faster.