Common use of Member Hold Clause in Contracts

Member Hold. Harmless - Except in the event that Member has primary coverage with another carrier or third party payer and except for applicable Copayments or Deductibles, Provider agrees to look solely to Health Plan or TPA for payment for Covered Services rendered under this Agreement and to accept payment made in accordance with the Agreement as payment in full. Provider will in no event, including but not limited to nonpayment, insolvency or breach of this Agreement, bill, charge, collect a deposit from, seek payment from, maintain any action at law or in equity or have any other recourse against a Member or person (other than Health Plan or TPA) acting on behalf of Member for Covered Services provided pursuant to this Agreement. This provision does not prohibit Provider from collecting charges for supplemental benefits or Copayments or Deductibles where appropriate, or for non-Covered Services provided to Members on a fee-for-service basis. This provision shall survive termination of the Agreement for Covered Services rendered prior to termination regardless of the cause giving rise to such termination and shall be construed to be for the benefit of the Member. This provision supersedes any oral or written agreement to the contrary now existing or hereafter entered into between Provider and Member or person acting on Member's behalf, insofar as such contrary agreement relates to liability for payment of Covered Services provided under this Agreement.

Appears in 4 contracts

Samples: Provider Group Affiliation Agreement, Practitioner Affiliation Agreement, Provider Group Affiliation Agreement

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Member Hold. Harmless - Except in the event that Member has primary coverage with another carrier or third party payer and except for applicable Copayments or Deductibles, Provider agrees to look solely to Health Plan or TPA for payment for Covered Services rendered under this Agreement and to accept payment made in accordance with the Agreement as payment in full. Provider will in no event, including but not limited to nonpayment, insolvency or breach of this Agreement, billxxxx, charge, collect a deposit from, seek payment from, maintain any action at law or in equity or have any other recourse against a Member or person (other than Health Plan or TPA) acting on behalf of Member for Covered Services provided pursuant to this Agreement. This provision does not prohibit Provider from collecting charges for supplemental benefits or Copayments or Deductibles where appropriate, or for non-Covered Services provided to Members on a fee-for-service basis. This provision shall survive termination of the Agreement for Covered Services rendered prior to termination regardless of the cause giving rise to such termination and shall be construed to be for the benefit of the Member. This provision supersedes any oral or written agreement to the contrary now existing or hereafter entered into between Provider and Member or person acting on Member's behalf, insofar as such contrary agreement relates to liability for payment of Covered Services provided under this Agreement.

Appears in 4 contracts

Samples: Provider Group Affiliation Agreement, Ancillary Provider Affiliation Agreement, Practitioner Affiliation Agreement

Member Hold. Harmless - Except in the event that Member has primary coverage with another carrier or third party payer and except for applicable Copayments or Deductibles, Provider agrees to look solely to Health Plan or TPA for payment for Covered Services rendered under this Agreement to Members and to accept payment made in accordance with the Agreement as payment in full, except to the extent that copayments and deductibles are specified in Member’s Certificate or as permitted under the Coordination of Benefits Section of this Agreement. Provider will in no event, including but not limited to nonpayment, insolvency or breach of this the Agreement, bill, charge, collect a deposit from, seek payment from, maintain any action at law or in equity or have any other recourse against a Member or person (other than Health Plan or TPAPlan) acting on behalf of Member for Covered Services provided pursuant to this the Agreement. This provision does not prohibit Provider from collecting charges for supplemental benefits or Copayments or Deductibles where appropriate, or for non-Covered Services provided to Members delivered on a fee-for-service basisbasis to Members who are informed in advance of their payment responsibility and the estimated charges. This provision shall survive termination of the Agreement for Covered Services rendered prior to termination regardless of the cause giving rise to such termination and shall be construed to be for the benefit of the Member. This provision supersedes any oral or written agreement to the contrary now existing or hereafter entered into between Provider and Member or person acting on Member's behalf, insofar as such contrary agreement relates to liability for payment of Covered Services provided under this Agreement.

Appears in 1 contract

Samples: Blue Cross Complete of Michigan Practitioner Affiliation Agreement

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Member Hold. Harmless - Except in the event that Member has primary coverage with another carrier or third party payer and except for applicable Copayments or Deductibles, Provider agrees to look solely to Health Plan or TPA for payment for Covered Services rendered under this Agreement to Members and to accept payment made in accordance with the Agreement as payment in full, except to the extent that copayments and deductibles are specified in Member’s Certificate or as permitted under the Coordination of Benefits Section of this Agreement. Provider will in no event, including but not limited to nonpayment, insolvency or breach of this the Agreement, billxxxx, charge, collect a deposit from, seek payment from, maintain any action at law or in equity or have any other recourse against a Member or person (other than Health Plan or TPAPlan) acting on behalf of Member for Covered Services provided pursuant to this the Agreement. This provision does not prohibit Provider from collecting charges for supplemental benefits or Copayments or Deductibles where appropriate, or for non-Covered Services provided to Members delivered on a fee-for-service basisbasis to Members who are informed in advance of their payment responsibility and the estimated charges. This provision shall survive termination of the Agreement for Covered Services rendered prior to termination regardless of the cause giving rise to such termination and shall be construed to be for the benefit of the Member. This provision supersedes any oral or written agreement to the contrary now existing or hereafter entered into between Provider and Member or person acting on Member's behalf, insofar as such contrary agreement relates to liability for payment of Covered Services provided under this Agreement.

Appears in 1 contract

Samples: Blue Cross Complete of Michigan Ancillary Provider Affiliation Agreement

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