Common use of HOW YOUR COVERED DENTAL SERVICES ARE PAID Clause in Contracts

HOW YOUR COVERED DENTAL SERVICES ARE PAID. Payments we make to you are personal and you cannot transfer or assign any of your right to receive payments under this agreement to another person or organization. Our allowance is the maximum amount to be paid for a covered dental service. We will not be responsible for more than the allowance even if more than one dentist renders a covered dental service. You must file all claims within one calendar year of the date you receive a covered dental service. Member submitted claims that arrive after this deadline are invalid unless:  it was not reasonably possible for you to file your claim prior to the filing deadline; AND  you file your claim as soon as possible but no later than ninety (90) calendar days after the filing deadline elapses (unless you are legally incapable). Our payments to you or the dentist fulfill our responsibility under this agreement. In accordance with Rhode Island General Law § 27-20-49, benefits may be assigned and with your written consent our payments can be made to a non-network dentist. Your benefits, however, are personal to you and cannot be assigned, in whole or in part, to another person or organization. Network dentists file claims for you and must do so within one year of providing a covered dental service to you. Non-network dentists may or may not file claims for you. If the non-network dentist does not file the claim on your behalf, you will need to file the claim yourself. To file a claim, please send us an itemized xxxx including the following:  patient's name;  your member identification number;  the name, address, and telephone number of the dentist who performed the service;  date and description of the service; AND  charge for that service. Please mail dental claims to: Blue Cross & Blue Shield of Rhode Island Dental Claims Administer X.X. Xxx 00000 Xxxxxxxxxx, XX 00000-0000 5.1 How Network Dentists Are Paid We pay network dentists directly for covered dental services. You are responsible for the coinsurance or deductibles (if any), if any, which may apply to a covered dental service. The copayments and deductibles you are responsible for are determined at the date of service and will not be retroactively adjusted for payments we make to providers under provider incentive, risk-sharing, care coordination, value-based or similar programs. In addition, reimbursement for covered dental services is always subject to your annual maximum benefit. Network dentists agree not to xxxx, charge, collect a deposit from, or in any way, seek reimbursement from you for a covered dental service, except for the coinsurance and deductible (if any) which may apply to a covered dental service. It is your obligation to pay a network dentist your coinsurance and deductible (if any). If you do not pay the network dentist, the dentist may decline to provide current or future services or may pursue payment from you. See Section 1.9 – Your Responsibility to Pay Your Dentists for more information.

HOW YOUR COVERED DENTAL SERVICES ARE PAID. Payments we make to you are personal and you cannot transfer or assign any of your right to receive payments under this agreement to another person or organization. Our allowance is the maximum amount to be paid for a covered dental service. We will not be responsible for more than the allowance even if more than one dentist renders a covered dental service. You must file all claims within one calendar benefit year of the date you receive a covered dental service. Member submitted claims that arrive after this deadline are invalid unless:  • it was not reasonably possible for you to file your claim prior to the filing deadline; AND  • you file your claim as soon as possible but no later than ninety (90) calendar days after the filing deadline elapses (unless you are legally incapable). Our payments to you or the dentist fulfill our responsibility under this agreement. In accordance with Rhode Island General Law § 27-20-49, benefits may be assigned and with your written consent our payments can be made to a non-network dentist. Your benefits, however, are personal to you and cannot be assigned, in whole or in part, to another person or organization. Network dentists dentist file claims for you and must do so within one year of providing a covered dental service to you. Non-network dentists dentist may or may not file claims for you. If the non-network dentist does not file the claim on your behalf, you will need to file the claim yourself. To file a claim, please send us an itemized xxxx bill including the following:  • patient's name;  • your member identification number;  • the name, address, and telephone number of the dentist who performed the service;  • date and description of the service; AND  • charge for that service. Please mail dental claims the claim to: Blue Cross & Blue Shield of Rhode Island Attention: Blue Cross Dental Claims Administer X.X. Xxx 00000 XxxxxxxxxxP. O. Box 219 Providence, XX 00000RI 02901-0000 5.1 How Network Dentists Are Paid We pay network dentists directly for covered dental services. You are responsible for the coinsurance or deductibles (if any), if any, which may apply to a covered dental service. The copayments and deductibles you are responsible for are determined at the date of service and will not be retroactively adjusted for payments we make to providers under provider incentive, risk-sharing, care coordination, value-based or similar programs. In addition, reimbursement for covered dental services is always subject to your annual maximum benefit. Network dentists agree not to xxxx, charge, collect a deposit from, or in any way, seek reimbursement from you for a covered dental service, except for the coinsurance and deductible (if any) which may apply to a covered dental service. It is your obligation to pay a network dentist your coinsurance and deductible (if any). If you do not pay the network dentist, the dentist may decline to provide current or future services or may pursue payment from you. See Section 1.9 – Your Responsibility to Pay Your Dentists for more information.0219

HOW YOUR COVERED DENTAL SERVICES ARE PAID. Payments we make to you are personal and you cannot transfer or assign any of your right to receive payments under this agreement to another person or organization. Our allowance is the maximum amount to be paid for a covered dental service. We will not be responsible for more than the allowance even if more than one dentist renders a covered dental service. You must file all claims within one calendar year of the date you receive a covered dental service. Member submitted claims that arrive after this deadline are invalid unless:  it was not reasonably possible for you to file your claim prior to the filing deadline; AND  you file your claim as soon as possible but no later than ninety (90) calendar days after the filing deadline elapses (unless you are legally incapable). Our payments to you or the dentist fulfill our responsibility under this agreement. In accordance with Rhode Island General Law § 27-20-49, benefits may be assigned and with your written consent our payments can be made to a non-network dentist. Your benefits, however, are personal to you and cannot be assigned, in whole or in part, to another person or organization. Network dentists file claims for you and must do so within one year of providing a covered dental service to you. Non-network dentists may or may not file claims for you. If the non-network dentist does not file the claim on your behalf, you will need to file the claim yourself. To file a claim, please send us an itemized xxxx including the following:  patient's name;  your member identification number;  the name, address, and telephone number of the dentist who performed the service;  date and description of the service; AND  charge for that service. Please mail dental claims the claim to: Blue Cross & Blue Shield of Rhode Island Attention: Blue Cross Dental Claims Administer X.X. P. O. Xxx 00000 000 Xxxxxxxxxx, XX 00000-0000 5.1 How Network Dentists Are Paid We pay network dentists directly for covered dental services. You are responsible for the coinsurance or deductibles (if any), if any, which may apply to a covered dental service. The copayments and deductibles you are responsible for are determined at the date of service and will not be retroactively adjusted for payments we make to providers under provider incentive, risk-sharing, care coordination, value-based or similar programs. In addition, reimbursement for covered dental services is always subject to your annual maximum benefit. Network dentists agree not to xxxx, charge, collect a deposit from, or in any way, seek reimbursement from you for a covered dental service, except for the coinsurance and deductible (if any) which may apply to a covered dental service. It is your obligation to pay a network dentist your coinsurance and deductible (if any). If you do not pay the network dentist, the dentist may decline to provide current or future services or may pursue payment from you. See Section 1.9 – Your Responsibility to Pay Your Dentists for more information.

HOW YOUR COVERED DENTAL SERVICES ARE PAID. Payments we make to you are personal and you cannot transfer or assign any of your right to receive payments under this agreement to another person or organization. Our allowance is the maximum amount to be paid for a covered dental service. We will not be responsible for more than the allowance even if more than one dentist renders a covered dental service. You must file all claims within one calendar benefit year of the date you receive a covered dental service. Member submitted claims that arrive after this deadline are invalid unless:  • it was not reasonably possible for you to file your claim prior to the filing deadline; AND  • you file your claim as soon as possible but no later than ninety (90) calendar days after the filing deadline elapses (unless you are legally incapable). Our payments to you or the dentist fulfill our responsibility under this agreement. In accordance with Rhode Island General Law § 27-20-49, benefits may be assigned and with your written consent our payments can be made to a non-network dentist. Your benefits, however, are personal to you and cannot be assigned, in whole or in part, to another person or organization. Network dentists file claims for you and must do so within one year of providing a covered dental service to you. Non-network dentists may or may not file claims for you. If the non-network dentist does not file the claim on your behalf, you will need to file the claim yourself. To file a claim, please send us an itemized xxxx bill including the following:  • patient's name;  • your member identification number;  • the name, address, and telephone number of the dentist who performed the service;  • date and description of the service; AND  • charge for that service. Please mail dental claims the claim to: Blue Cross & Blue Shield of Rhode Island Attention: Blue Cross Dental Claims Administer X.X. Xxx 00000 XxxxxxxxxxP. O. Box 219 Providence, XX 00000RI 02901-0000 5.1 How Network Dentists Are Paid We pay network dentists directly for covered dental services. You are responsible for the coinsurance or deductibles (if any), if any, which may apply to a covered dental service. The copayments and deductibles you are responsible for are determined at the date of service and will not be retroactively adjusted for payments we make to providers under provider incentive, risk-sharing, care coordination, value-based or similar programs. In addition, reimbursement for covered dental services is always subject to your annual maximum benefit. Network dentists agree not to xxxx, charge, collect a deposit from, or in any way, seek reimbursement from you for a covered dental service, except for the coinsurance and deductible (if any) which may apply to a covered dental service. It is your obligation to pay a network dentist your coinsurance and deductible (if any). If you do not pay the network dentist, the dentist may decline to provide current or future services or may pursue payment from you. See Section 1.9 – Your Responsibility to Pay Your Dentists for more information.0219

HOW YOUR COVERED DENTAL SERVICES ARE PAID. Payments we make to you are personal and you cannot transfer or assign any of your right to receive payments under this agreement to another person or organization. Our allowance is the maximum amount to be paid for a covered dental service. We will not be responsible for more than the allowance even if more than one dentist renders a covered dental service. You must file all claims within one calendar benefit year of the date you receive a covered dental service. Member submitted claims that arrive after this deadline are invalid unless:  • it was not reasonably possible for you to file your claim prior to the filing deadline; AND  • you file your claim as soon as possible but no later than ninety (90) calendar days after the filing deadline elapses (unless you are legally incapable). Our payments to you or the dentist fulfill our responsibility under this agreement. In accordance with Rhode Island General Law § 27-20-49, benefits may be assigned and with your written consent our payments can be made to a non-network dentist. Your benefits, however, are personal to you and cannot be assigned, in whole or in part, to another person or organization. Network dentists file claims for you and must do so within one year of providing a covered dental service to you. Non-network dentists may or may not file claims for you. If the non-network dentist does not file the claim on your behalf, you will need to file the claim yourself. To file a claim, please send us an itemized xxxx including the following:  • patient's name;  • your member identification number;  • the name, address, and telephone number of the dentist who performed the service;  • date and description of the service; AND  • charge for that service. Please mail dental claims the claim to: Blue Cross & Blue Shield of Rhode Island Attention: Blue Cross Dental Claims Administer X.X. P. O. Xxx 00000 000 Xxxxxxxxxx, XX 00000-0000 5.1 How Network Dentists Are Paid We pay network dentists directly for covered dental services. You are responsible for the coinsurance or deductibles (if any), if any, which may apply to a covered dental service. The copayments and deductibles you are responsible for are determined at the date of service and will not be retroactively adjusted for payments we make to providers under provider incentive, risk-sharing, care coordination, value-based or similar programs. In addition, reimbursement for covered dental services is always subject to your annual maximum benefit. Network dentists agree not to xxxx, charge, collect a deposit from, or in any way, seek reimbursement from you for a covered dental service, except for the coinsurance and deductible (if any) which may apply to a covered dental service. It is your obligation to pay a network dentist your coinsurance and deductible (if any). If you do not pay the network dentist, the dentist may decline to provide current or future services or may pursue payment from you. See Section 1.9 – Your Responsibility to Pay Your Dentists for more information.

HOW YOUR COVERED DENTAL SERVICES ARE PAID. Payments we make to you are personal and you cannot transfer or assign any of your right to receive payments under this agreement to another person or organization. Our allowance is the maximum amount to be paid for a covered dental service. We will not be responsible for more than the allowance even if more than one dentist renders a covered dental service. You must file all claims within one calendar benefit year of the date you receive a covered dental service. Member submitted claims that arrive after this deadline are invalid unless:  • it was not reasonably possible for you to file your claim prior to the filing deadline; AND  • you file your claim as soon as possible but no later than ninety (90) calendar days after the filing deadline elapses (unless you are legally incapable). Our payments to you or the dentist fulfill our responsibility under this agreement. In accordance with Rhode Island General Law § 27-20-49, benefits may be assigned and with your written consent our payments can be made to a non-network dentist. Your benefits, however, are personal to you and cannot be assigned, in whole or in part, to another person or organization. Network dentists dentist file claims for you and must do so within one year of providing a covered dental service to you. Non-network dentists dentist may or may not file claims for you. If the non-network dentist does not file the claim on your behalf, you will need to file the claim yourself. To file a claim, please send us an itemized xxxx including the following:  • patient's name;  • your member identification number;  • the name, address, and telephone number of the dentist who performed the service;  • date and description of the service; AND  • charge for that service. Please mail dental claims the claim to: Blue Cross & Blue Shield of Rhode Island Attention: Blue Cross Dental Claims Administer X.X. P. O. Xxx 00000 000 Xxxxxxxxxx, XX 00000-0000 5.1 How Network Dentists Are Paid We pay network dentists directly for covered dental services. You are responsible for the coinsurance or deductibles (if any), if any, which may apply to a covered dental service. The copayments and deductibles you are responsible for are determined at the date of service and will not be retroactively adjusted for payments we make to providers under provider incentive, risk-sharing, care coordination, value-based or similar programs. In addition, reimbursement for covered dental services is always subject to your annual maximum benefit. Network dentists agree not to xxxx, charge, collect a deposit from, or in any way, seek reimbursement from you for a covered dental service, except for the coinsurance and deductible (if any) which may apply to a covered dental service. It is your obligation to pay a network dentist your coinsurance and deductible (if any). If you do not pay the network dentist, the dentist may decline to provide current or future services or may pursue payment from you. See Section 1.9 – Your Responsibility to Pay Your Dentists for more information.

HOW YOUR COVERED DENTAL SERVICES ARE PAID. Payments we make to you are personal and you cannot transfer or assign any of your right to receive payments under this agreement to another person or organization. Our allowance is the maximum amount to be paid for a covered dental service. We will not be responsible for more than the allowance even if more than one dentist renders a covered dental service. You must file all claims within one calendar benefit year of the date you receive a covered dental service. Member submitted claims that arrive after this deadline are invalid unless:  it was not reasonably possible for you to file your claim prior to the filing deadline; AND  you file your claim as soon as possible but no later than ninety (90) calendar days after the filing deadline elapses (unless you are legally incapable). Our payments to you or the dentist fulfill our responsibility under this agreement. In accordance with Rhode Island General Law § 27-20-49, benefits may be assigned and with your written consent our payments can be made to a non-network dentist. Your benefits, however, are personal to you and cannot be assigned, in whole or in part, to another person or organization. Network dentists file claims for you and must do so within one year of providing a covered dental service to you. Non-network dentists may or may not file claims for you. If the non-network dentist does not file the claim on your behalf, you will need to file the claim yourself. To file a claim, please send us an itemized xxxx including the following:  patient's name;  your member identification number;  the name, address, and telephone number of the dentist who performed the service;  date and description of the service; AND  charge for that service. Please mail dental claims to: Blue Cross & Blue Shield of Rhode Island Dental Claims Administer X.X. Xxx 00000 Xxxxxxxxxx, XX 00000-0000 5.1 How Network Dentists Are Paid We pay network dentists directly for covered dental services. You are responsible for the coinsurance or deductibles (if any), if any, which may apply to a covered dental service. The copayments and deductibles you are responsible for are determined at the date of service and will not be retroactively adjusted for payments we make to providers under provider incentive, risk-sharing, care coordination, value-based or similar programs. In addition, reimbursement for covered dental services is always subject to your annual maximum benefit. Network dentists agree not to xxxx, charge, collect a deposit from, or in any way, seek reimbursement from you for a covered dental service, except for the coinsurance and deductible (if any) which may apply to a covered dental service. It is your obligation to pay a network dentist your coinsurance and deductible (if any). If you do not pay the network dentist, the dentist may decline to provide current or future services or may pursue payment from you. See Section 1.9 – Your Responsibility to Pay Your Dentists for more information.

HOW YOUR COVERED DENTAL SERVICES ARE PAID. Payments we make to you are personal and you cannot transfer or assign any of your right to receive payments under this agreement to another person or organization. Our allowance is the maximum amount to be paid for a covered dental service. We will not be responsible for more than the allowance even if more than one dentist renders a covered dental service. You must file all claims within one calendar benefit year of the date you receive a covered dental service. Member submitted claims that arrive after this deadline are invalid unless:  it was not reasonably possible for you to file your claim prior to the filing deadline; AND  you file your claim as soon as possible but no later than ninety (90) calendar days after the filing deadline elapses (unless you are legally incapable). Our payments to you or the dentist fulfill our responsibility under this agreement. In accordance with Rhode Island General Law § 27-20-49, benefits may be assigned and with your written consent our payments can be made to a non-network dentist. Your benefits, however, are personal to you and cannot be assigned, in whole or in part, to another person or organization. Network dentists file claims for you and must do so within one year of providing a covered dental service to you. Non-network dentists may or may not file claims for you. If the non-network dentist does not file the claim on your behalf, you will need to file the claim yourself. To file a claim, please send us an itemized xxxx bill including the following:  patient's name;  your member identification number;  the name, address, and telephone number of the dentist who performed the service;  date and description of the service; AND  charge for that service. Please mail dental claims the claim to: Blue Cross & Blue Shield of Rhode Island Attention: Blue Cross Dental Claims Administer X.X. Xxx 00000 XxxxxxxxxxP. O. Box 219 Providence, XX 00000RI 02901-0000 5.1 How Network Dentists Are Paid We pay network dentists directly for covered dental services. You are responsible for the coinsurance or deductibles (if any), if any, which may apply to a covered dental service. The copayments and deductibles you are responsible for are determined at the date of service and will not be retroactively adjusted for payments we make to providers under provider incentive, risk-sharing, care coordination, value-based or similar programs. In addition, reimbursement for covered dental services is always subject to your annual maximum benefit. Network dentists agree not to xxxx, charge, collect a deposit from, or in any way, seek reimbursement from you for a covered dental service, except for the coinsurance and deductible (if any) which may apply to a covered dental service. It is your obligation to pay a network dentist your coinsurance and deductible (if any). If you do not pay the network dentist, the dentist may decline to provide current or future services or may pursue payment from you. See Section 1.9 – Your Responsibility to Pay Your Dentists for more information.0219