For non-network providers. When a covered service is received from a non-network provider, the eligible service expense is the minimum amount required by applicable federal or state law to be paid to the non-network provider for the service. If and only if there is no minimum amount required by applicable federal or state law, then the eligible service expense for a non-network provider shall be as determined below.
Appears in 5 contracts
Samples: ambetter.sunshinehealth.com, api.centene.com, api.centene.com