In-Network Provider Sample Clauses
In-Network Provider. If ▇▇▇▇ or any other provider performing Non-Member Services for you under this Agreement is a participating provider within your insurance or health plan network then, in exchange for the Non-Member Services selected by you and provided during the term of this Agreement, ▇▇▇▇ or another provider performing the selected Non-Member Services will ▇▇▇▇ and attempt to collect applicable fees for such Non-Member Services from your insurer or health network. Other than copayment, which may be collected at the time of service depending on your insurance or health plan’s requirements, ▇▇▇▇ or another provider performing the selected Non-Member Services will ▇▇▇▇ you after receiving the claims processing outcome for your Non-Member Services from your insurer or health plan. Such ▇▇▇▇ would reflect your payment obligations under your specific insurance or health plan and is to be paid within thirty (30) days. If you or ▇▇▇▇ terminate this Agreement, these fees will not be refunded to you for any reason.
In-Network Provider. (i) If Distributor is an in-network provider for a potential patient’s payor, Distributor shall offer to serve the prospective patient directly through Distributor’s retail pharmacy program. If the prospective patient accepts Distributor’s offer to serve, the prospective patient becomes a Patient (as that term is defined below)). If the prospective patient does not accept Distributor’s offer to serve, such prospective patient shall be transferred to the administrator of CTI’s Call Center and Reimbursement Support Services program in accordance with the procedure set forth below in Section 3.1.3(b).
(ii) In accordance with a physician’s prescription, Distributor shall dispense and deliver the Product and Delivery Device to patients located in the Territory who are referred to Distributor by their treating physician or provider (hospital, outpatient clinic, infusion center, etc.) or by a managed care entity (“Patients”).
(iii) Distributor shall deliver the Product and Delivery Device via Fed Ex, UPS or other common carrier at its option,standard overnight delivery service (or another mutually agreed to delivery service) to Patients at their home, or to any other location at which the Patient will receive inhalation therapy, such as a hospital, clinic or infusion center, all as designated by such Patient. Distributor shall track each shipment of Product and Delivery Device to Patients and confirm receipt. Distributor shall use its best efforts to dispense Product such that Product having the earliest expiration date is shipped first from available inventory.
(iv) Distributor shall be responsible for all billing and collection in connection with its sales of Product and the Delivery Device to Patients. Distributor shall obtain a Patient’s authorization for Distributor to directly ▇▇▇▇ the Patient’s insurance company, government payor or other third party payor and to have such benefit payments made directly to Distributor. Distributor shall use reasonable efforts to obtain reimbursement clearance, if necessary, for anticipated subsequent orders from a Patient prior to actual receipt of the subsequent order.
(v) Distributor shall ensure that a licensed pharmacist or nurse, to the extent permitted by law, who is properly trained to answer Product-related questions or requests for emergency supplies of Product, is available by telephone, on a designated toll-free number, (i) from 8:00 a.m. to 8:00 p.m. Eastern Time, Monday through Friday, except Distributor holid...