Maximum Reimbursement Allowances. Except as set forth below, the Maximum Reimbursement Allowance for Covered Services rendered to BlueLincs HMO Members shall be as set forth in the Agreement.
Maximum Reimbursement Allowances. Except as set forth below, the Maximum Reimbursement Allowance for Covered Services rendered to Blue Advantage PPO Members shall be as set forth in the Agreement.
Maximum Reimbursement Allowances. The basis for reimbursement for Covered Services rendered to Members will be the lesser of Group's Usual Charge or The Plan's Maximum Reimbursement Allowance. Reimbursement shall be made according to The Plan's medical policies and reimbursement guidelines pertaining to subjects such as multiple surgical procedures, surgical assistance, global surgical services, coding and unbundling.
Maximum Reimbursement Allowances. 3.0 The basis for reimbursement for Covered Services provided to NativeBlue Members will be the lesser of Group's Usual Charge or The Plan's Maximum Reimbursement Allowance set forth below. Reimbursement shall be made according to The Plan's medical policies and reimbursement guidelines pertaining to subjects such as multiple surgical procedures, surgical assistance, global surgical services, coding and unbundling.
Maximum Reimbursement Allowances. Maximum Reimbursement Allowances for Covered Services provided to NativeBlue Members shall be based on base Medicare reimbursements, excluding any Medicare adjustments using information on the claim, and multiplied by the applicable percentage set forth in the sections below. Services for which a Medicare reimbursement rate is not available will be reimbursed in accordance with The Plan's fee schedule in effect as of the date of service. For purposes of this NativeBlue Addendum, the Medicare reimbursement rate only establishes the Maximum Reimbursement Allowance. All provisions of the Agreement remain applicable. The Maximum Reimbursement Allowance will not include any additional payments that may be permitted under the Medicare laws or regulations which are not directly attributable to a specific claim, including but not limited to, disproportionate share and graduate medical education payments. Any changes to the Medicare reimbursement amount will be implemented by The Plan within thirty (30) days after the effective date that such change is implemented by the Centers for Medicaid and Medicare Services, or its successor.
Maximum Reimbursement Allowances. Maximum Reimbursement Allowances for Covered Services provided to Blue Plan65 Select Members shall be determined as follows:
