Common use of Member Protection Provision Clause in Contracts

Member Protection Provision. a. Provider hereby agrees that in no event, including, but not limited to nonpayment by Payor, Xxxxx’s insolvency or breach of this Agreement shall Provider bill, charge, collect a deposit from, seek compensation, remuneration or reimbursement from, or have any recourse against a Member or person acting on the Member’s behalf, other than Payor, for services provided pursuant to this Agreement. This provision shall not prohibit collection of copayments, co-insurance or deductibles, which have not otherwise been paid by a primary or secondary carrier in accordance with regulatory standards for coordination of benefits, from Members in accordance with the terms of the Member’s Benefit Plan. b. Provider agrees, in the event of the Payor’s insolvency, to continue to provide the services promised in this Agreement to Members for the duration of the period for which premiums on behalf of the Member were paid or until the Member’s discharge from inpatient facilities, whichever time is greater. c. Notwithstanding any other provision of the Agreement, nothing in the Agreement shall be construed to modify the rights and benefits contained in the Member’s Benefit Plan. d. Provider may not bill the Member for Covered Services (except for copayments, coinsurance and deductibles) where UBH or Payor, as applicable, denies payments because Provider has failed to comply with the terms or conditions of this Agreement. e. Provider further agrees: (i) that the provisions of (a), (b), (c), and (d) of this Section shall survive termination of this Agreement regardless of the cause giving rise to termination and shall be construed to be for the benefit of the Members; and (ii) that this Section supersedes any oral or written or written contrary agreement now existing or hereafter entered into between Provider and Members or persons acting on the Members’ behalf. f. If Provider contracts with other health care providers who agree to provide Covered Services to Members with the expectation of receiving payment directly or indirectly from Payor, such providers must agree to abide by the provisions of (a), (b), (c), (d), and (e) of this section.

Member Protection Provision. a. Provider hereby agrees that in no event, including, but not limited to nonpayment by Payor, Xxxxx’s insolvency or breach of this Agreement shall Provider bill, charge, collect a deposit from, seek compensation, remuneration or reimbursement from, or have any recourse against a Member or person acting on the Member’s behalf, other than Payor, for services provided pursuant to this Agreement. This provision shall not prohibit collection of copayments, co-insurance or deductibles, which have not otherwise been paid by a primary or secondary carrier in accordance with regulatory standards for coordination of benefits, from Members in accordance with the terms of the Member’s Benefit Plan. b. Provider agrees, in the event of the Payor’s insolvency, to continue to provide the services promised in this Agreement to Members for the duration of the period for which premiums on behalf of the Member were paid or until the Member’s discharge from inpatient facilities, whichever time is greater. c. Notwithstanding any other provision of the Agreement, nothing in the Agreement shall be construed to modify the rights and benefits contained in the Member’s Benefit Plan. d. Provider may not bill the Member for Covered Services (except for copayments, coinsurance and deductibles) where UBH or Payor, as applicable, denies payments because Provider has failed to comply with the terms or conditions of this Agreement. e. Provider further agrees: (i) that the provisions of (a), (b), (c), and (d) of this Section shall survive termination of this Agreement regardless of the cause giving rise to termination and shall be construed to be for the benefit of the Members; and (ii) that this Section supersedes any oral or written or written contrary agreement now existing or hereafter entered into between Provider and Members or persons acting on the Members’ behalf.written f. If Provider contracts with other health care providers who agree to provide Covered Services to Members with the expectation of receiving payment directly or indirectly from Payor, such providers must agree to abide by the provisions of (a), (b), (c), (d), and (e) of this section.

Member Protection Provision. a. Provider hereby agrees that in In no event, including, but not limited to, non- payment by Payor or an intermediary for Covered Services rendered to nonpayment Members by PayorProvider, Xxxxx’s insolvency of Payor or an intermediary, or breach of any term or condition of this Agreement Agreement, shall Provider bill, charge, collect a deposit from, seek compensation, remuneration or reimbursement from, or have any recourse against a any Member or person persons acting on behalf of the Member’s behalf, other than UBH, Payor, or an intermediary, as applicable, for Covered Services eligible for reimbursement under this Agreement; provided, however, that Provider may collect from a Member the copayment, deductible or coinsurance for which the Member is responsible under the Benefit Plan, or charges for services provided pursuant to this Agreement. This provision shall not prohibit collection of copayments, co-insurance or deductibles, which have not otherwise been paid by a primary or secondary carrier in accordance with regulatory standards for coordination of benefits, from Members in accordance with the terms of covered under the Member’s Benefit Plan. b. . This Agreement does not prohibit Provider agrees, in the event of the Payor’s insolvency, from agreeing to continue the provision of non-covered health care services solely at a Member’s expense, as long as Provider has clearly informed the Member that UBH or the Payor may not cover or continue to cover a specific health care service or health care services. The foregoing sentence does not apply to Provider when Provider is employed full-time on the staff of UBH or Payor and has agreed to provide the health care services promised in exclusively to their own Members and no others. Except as provided herein, this provision does not prohibit Provider from pursing any available legal remedy. The provisions of this section shall: (a) apply to all Covered Services rendered while this Agreement is in force; (b) with respect to Members for the duration of the period for which premiums on behalf of the Member were paid or until the Member’s discharge from inpatient facilities, whichever time is greater. c. Notwithstanding any other provision of the Agreement, nothing in the Agreement shall be construed to modify the rights and benefits contained in the Member’s Benefit Plan. d. Provider may not bill the Member for Covered Services (except for copaymentsrendered while this Agreement is in force, coinsurance and deductibles) where UBH or Payor, as applicable, denies payments because Provider has failed to comply with survive the terms or conditions of this Agreement. e. Provider further agrees: (i) that the provisions of (a), (b), (c), and (d) of this Section shall survive termination of this Agreement regardless of the cause giving rise to termination and shall of termination; (c) be construed to be for the benefit of the Members; and (iid) that this Section supersedes supersede any oral or written or written contrary agreement now agreement, existing or hereafter subsequently entered into into, between Provider and Members a Member or persons person acting on a Member’s behalf, that requires the Members’ behalfMember to pay for such Covered Services. Provider, or Provider's agent, trustee, or assignee, may not maintain any action at law against a Member to collect sums owed to Provider by UBH or Payor. f. If Provider contracts with other health care providers who agree to provide Covered Services to Members with the expectation of receiving payment directly or indirectly from Payor, such providers must agree to abide by the provisions of (a), (b), (c), (d), and (e) of this section.

Member Protection Provision. a. Provider hereby agrees that in no event, including, but not limited to nonpayment by Payor, XxxxxPayor’s insolvency or breach of this Agreement shall Provider bill, charge, collect a deposit from, seek compensation, remuneration or reimbursement from, or have any recourse against a Member or person acting on the Member’s behalf, other than Payor, for services provided pursuant to this Agreement. This provision shall not prohibit collection of copayments, co-insurance or deductibles, which have not otherwise been paid by a primary or secondary carrier in accordance with regulatory standards for coordination of benefits, from Members in accordance with the terms of the Member’s Benefit Plan. b. Provider agrees, in the event of the Payor’s insolvency, to continue to provide the services promised in this Agreement to Members for the duration of the period for which premiums on behalf of the Member were paid or until the Member’s discharge from inpatient facilities, whichever time is greater. c. Notwithstanding any other provision of the Agreement, nothing in the Agreement shall be construed to modify the rights and benefits contained in the Member’s Benefit Plan. d. Provider may not bill the Member for Covered Services (except for copayments, coinsurance and deductibles) where UBH United or Payor, as applicable, denies payments because Provider has failed to comply with the terms or conditions of this Agreement. e. Provider further agrees: (i) that the provisions of (a), (b), (c), and (d) of this Section shall survive termination of this Agreement regardless of the cause giving rise to termination and shall be construed to be for the benefit of the Members; and (ii) that this Section supersedes any oral or written or written contrary agreement now existing or hereafter entered into between Provider and Members or persons acting on the Members’ behalf. f. If Provider contracts with other health care providers who agree to provide Covered Services to Members with the expectation of receiving payment directly or indirectly from Payor, such providers must agree to abide by the provisions of (a), (b), (c), (d), and (e) of this section.