Limitation on Use of Rental Networks or Discounted Fee Schedules. Company agrees that, whenever it pays a Non-Participating Physician based upon a fee schedule established by another entity, (1) Company shall, upon request by such Non-Participating Physician, provide the name, address and telephone number of such entity and (2) Company shall disclose on each EOB or Remittance Advice, the identity of such entity in sufficient detail for the Physician to identify it; provided, however, that such obligation shall not apply to the BlueCard program or any similar national account delivery program governed by the BCBSA or where the identity of such entity is contained on a Plan Member’s identification card. In addition to the foregoing, Company agrees that it shall endeavor to include in contracts entered into with such entities following the Effective Date, an obligation on the part of such entities to furnish Non-Participating Physicians a copy, upon request, of the signed agreement showing that the Non-Participating Physician agreed to be bound by that entity’s fee schedule with respect to services provided to a Plan Member. The Parties are precluded from using anything in this § 7.29(p) in connection with efforts to obtain legislative or regulatory changes, including but not limited to the subject of this section, the content of this section, or the relief in this section. The parties are free to pursue, support, or oppose any proposed legislative or regulatory changes related to the subject matter of this section.
Limitation on Use of Rental Networks or Discounted Fee Schedules. Company agrees that, whenever it pays a Non-Participating Physician based upon a fee schedule established by another entity, (A) Company shall, upon request by such Non-Participating Physician, provide the name, address and telephone number of such entity and (B) Company shall disclose on each EOB or Remittance Advice, the identity of such entity in sufficient detail for the Physician to identify it; provided, however, that such obligation shall not apply where the identity of such entity is contained on a Plan Member’s identification card. Within sixty (60) days of a written request by the Physician, Company will provide the Physician with a copy of the signed authorization to use the fee, or else Company will not be entitled to the fee based on that contract. Company also agrees that it will not require Physicians to participate in its rental networks as a condition of participation in Company’s other networks or products. The Parties are precluded from using anything in this § 7.29(p) in connection with efforts to obtain legislative or regulatory changes, including but not limited to the subject of this section, the content of this section, or the relief in this section. The parties are free to pursue, support, or oppose any proposed legislative or regulatory changes related to the subject matter of this section.
