Common use of In-Network Services Clause in Contracts

In-Network Services. Subject to Article III, Section 2.7, Timely Payment Requirement, the MCO must make timely payment within thirty (30) calendar days for clean claims to in-network providers for Medically Necessary, covered Contract services when: 1. Services were rendered to treat a medical emergency; 2. Services were rendered under the terms of the MCO’s Contract with the provider; 3. Services were prior authorized; or 4. Retro-authorization meeting medical necessity has been granted due to the nature of service.

In-Network Services. Subject to Article III, Section 2.7, Timely Payment Requirement, the MCO must make timely payment within thirty (30) calendar days for clean claims to in-network providers for Medically Necessary, covered Contract services rendered by in-network providers when: 1. Services were rendered to treat a medical emergency; 2. Services were rendered under the terms of the MCO’s Contract with the provider;; or 3. Services were prior authorized; or 4. Retro-authorization meeting medical necessity has been granted due to the nature of service.

In-Network Services. Subject to Article III, Section 2.7, Timely Payment Requirement, the MCO must make timely payment within thirty (30) calendar days for clean claims to in-network providers for Medically Necessary, covered Contract services when: 1. Services were rendered to treat a medical emergency; 2. Services were rendered under the terms of the MCO’s Contract with the provider; 3. Services were prior authorized; or 4. Retro-authorization meeting medical necessity has been granted due to the nature of service.

In-Network Services. Subject to Article III, Section 2.7, Timely Payment Requirement, the MCO must make timely payment within thirty (30) calendar days for clean claims to in-network providers for Medically Necessary, covered Contract services rendered by in-network providers when: 1. Services were rendered to treat a medical emergency; 2. Services were rendered under the terms of the MCO’s Contract with the provider;; or 3. Services were prior authorized; or 4. Retro-authorization meeting medical necessity has been granted due to the nature of service.

In-Network Services. Subject to Article III, Section 2.73.7, Timely Payment Requirement, the MCO must make timely payment within thirty (30) calendar days for clean claims to in-network providers for Medically Necessary, covered Contract services when: 1. Services were rendered to treat a medical emergency; 2. Services were rendered under the terms of the MCO’s Contract with the provider; 3. Services were prior authorized; or 4. Retro-authorization meeting medical necessity has been granted due to the nature of service.

In-Network Services. Subject to Article III, Section 2.7, Timely Payment Requirement, the MCO must make timely payment within thirty (30) 30 calendar days for clean claims to in-network providers for Medically Necessary, covered Contract contract services rendered by in- network providers when: 1. Services were rendered to treat a medical emergency;, or 2. Services were rendered under the terms of the MCO’s Contract contract with the provider;, or 3. Services were prior authorized; or 4. Retro-authorization meeting medical necessity has been granted due to the nature of service.

In-Network Services. Subject to Article III, Section 2.72.7.7, Timely Payment Requirement, the MCO must make timely payment within thirty (30) calendar days for clean claims to in-network providers for Medically Necessary, covered Contract services when: 1. Services were rendered to treat a medical emergency; 2. Services were rendered under the terms of the MCO’s Contract with the provider; 3. Services were prior authorized; or 4. Retro-authorization meeting medical necessity has been granted due to the nature of service.