Common use of Managed Care Program Requirements Clause in Contracts

Managed Care Program Requirements. SHL's Managed Care Program requires the Insured, Plan Providers and SHL to work together. All Plan Providers have agreed to participate in SHL’s Managed Care Program. Plan Providers have agreed to accept SHL’s Reimbursement Schedule amount as payment in full for Covered Services, less the Insured’s payment of any applicable Calendar Year Deductible, Copayment or Coinsurance amount, whereas Non-Plan Providers have not. In no event will SHL pay more than the maximum payment allowance established in the SHL Reimbursement Schedule. It is the Insured's responsibility to verify that the Provider selected is a Plan Provider before receiving any non-Emergency Services and to comply with all other rules of SHL’s Managed Care Program. Benefits payable for expenses incurred in connection with Covered Services which are not Prior Authorized by SHL’s Managed Care Program will be reduced to 50% of what the Insured would have received if the services had been Prior Authorized.

Managed Care Program Requirements. SHL's Managed Care Program requires the Insured, Plan Providers and SHL to work together. • All Plan Providers have agreed to participate in SHL’s Managed Care Program. Plan Providers have agreed to accept SHL’s Reimbursement Schedule amount as payment in full for Covered Services, less the Insured’s payment of any applicable Calendar Year DeductibleCopayment, Copayment Deductible or Coinsurance amount, whereas Non-Plan Providers have not. In no event will SHL pay more than the maximum payment allowance established in the SHL Reimbursement Schedule. • It is the Insured's responsibility to verify that the Provider selected is a Plan Provider before receiving any non-Emergency Services and to comply with all other rules of SHL’s Managed Care Program. • Benefits payable for expenses incurred in connection with Covered Services which are not Prior Authorized certified by SHL’s Managed Care Program will be reduced to 50% of what the Insured would have received if the services had been Prior Authorizedcertified.

Managed Care Program Requirements. SHL's Managed Care Program requires Programrequires the Insured, Plan Providers and SHL to SHLto work together. All Plan Providers have agreed to participate in SHL’s Managed Care Program. Plan Providers have agreed to accept SHL’s Reimbursement Schedule amount as payment in full for Covered Services, less the Insured’s payment of any applicable Calendar Year Deductible, Copayment or Coinsurance amount, whereas Non-Plan Providers have not. In no event will SHL pay more than the maximum payment allowance established in the SHL Reimbursement SHLReimbursement Schedule. It is the Insured's responsibility to verify that the Provider selected is a Plan Provider before receiving any non-Emergency Services and to comply with all other rules of SHL’s Managed Care Program. Benefits payable for expenses incurred in connection with Covered Services which are not Prior Authorized by SHL’s Managed Care Program will Programwill be reduced to 50% of what the Insured would have received if the services had been Prior Authorized.

Managed Care Program Requirements. SHL's Managed Care Program requires the Insured, Plan Providers and SHL to work together. All Plan Providers have agreed to participate in SHL’s Managed Care Program. Plan Providers have agreed to accept SHL’s Reimbursement Schedule amount as payment in full for Covered Services, less the Insured’s payment of any applicable Calendar Year Deductible, Copayment or Coinsurance amount, whereas Non-Plan Providers have not. In no event will SHL pay more than the maximum payment allowance established in the SHL Reimbursement Schedule. It is the Insured's responsibility to verify that the Provider selected is a Plan Provider before receiving any non-Emergency Services and to comply with all other rules of SHL’s Managed Care Program. Benefits payable for expenses incurred in connection with Covered Services which are not Prior Authorized certified by SHL’s Managed Care Program will be reduced to 50% of what the Insured would have received if the services had been Prior Authorizedcertified.