Common use of Member’s Responsibility in Seeking Covered Benefits and Services Clause in Contracts

Member’s Responsibility in Seeking Covered Benefits and Services. You are solely responsible for selecting a provider when obtaining Health Care Services and for verifying whether that provider is a Participating Provider at the time Health Care Services are rendered. You are also responsible for determining any corresponding payment options at the time the Health Care Services are rendered. If a Member does not follow these access rules, he risks having the services and supplies received not covered under this Contract. In such a circumstance, any payment that AvMed may make will not exceed the Maximum Allowable Payment and the Member will be responsible for reimbursing AvMed for the services and supplies received. It is the Member's responsibility when seeking benefits under this Contract to identify himself as a Member of AvMed.

Member’s Responsibility in Seeking Covered Benefits and Services. You are solely responsible for selecting a provider when obtaining Health Care Services and for verifying whether that provider is a Participating Provider at the time Health Care Services are rendered. You are also responsible for determining any corresponding payment options options, at the time the Health Care Services are rendered. If a Member does not follow these access rules, he risks having the services and supplies received not covered under this Contract. In such a circumstance, any payment that AvMed may make will not exceed the Maximum Allowable Payment and the Member will be responsible for reimbursing AvMed for the services and supplies received. It is the Member's responsibility when seeking benefits under this Contract to identify himself as a Member of AvMed.