Member Held Harmless Sample Clauses

Member Held Harmless. Except for cost sharing pursuant to the Hawaii Medicaid State Plan, Provider shall look solely to Company for compensation for Covered Services rendered to Members, and Provider agrees that in no event (including non-payment by Company, insolvency of Company or breach of the Agreement) shall Provider bill, charge, collect a deposit from, seek compensation, remuneration or reimbursement from, or have any recourse against any Member, person acting on the Member’s behalf, or any Health Plan for Covered Services provided under the Agreement. Provider shall accept the payment from Company as payment in full for all Covered Services and cannot charge the Member for any cost of a Covered Services whether or not the service was reimbursed by the Company and/or a Health Plan. Provider shall not bill Members for Covered Services in any amount greater than would be owed if a Health Plan provided the services directly (i.e., no balance billing by Provider). Without limiting the foregoing, Provider shall not seek payment from Members for reasons including (i) amounts denied because billed charges were not customary or reasonable, (ii) Provider’s failure to obtain authorization for services delivered, (iii) clinical data that was not submitted promptly, or (iv) Provider’s failure to submit a Claim in accordance with the appropriate billing procedures or within the appropriate time frame, or in accordance with commonly accepted standard coding practices.

Member Held Harmless. RPO hereby agrees on behalf of itself and all RPO Providers that in no event, including, but not limited to; nonpayment by Texas HealthSpring, an Affiliate, or a Payor, insolvency of Texas HealthSpring, such Affiliate, or a Payor, or breach of this Agreement, shall RPO or RPO Providers bill, charge, collect a deposit from, seek compensation, r▇▇▇▇eration, or reimbursement from, or have any recourse against Members or persons other than Texas Health Spring or a Payor acting on their behalf for Contracted Services provided pursuant to this Agreement. This provision shall not prohibit collection of supplemental charges or Copayments made in accordance with the terms of the applicable Benefit Program. RPO further agrees an behalf of itself and all RPO Providers that (a) this provision shall survive the termination of this Agreement regardless of the cause giving rise to termination and shall be construed to be for the benefit of Members; and (b) this provision supersedes any oral or written contrary agreement now existing or hereafter entered into between RPO and Members or persons acting on their behalf. Any modification, addition, or deletion to the provisions of this clause shall be effective on a date no earlier than fifteen (15) days after the State regulatory agency has received written notice of such proposed change and has approved such change.