Common use of No Billing of Members (Member Hold Harmless Provision) Clause in Contracts

No Billing of Members (Member Hold Harmless Provision). With the exception of Copayments and charges for non-Covered Services delivered on a fee-for-service basis to Members, Medical Group and its Participating Providers shall in no event, including, without limitation, non-payment by PacifiCare, insolvency of PacifiCare, or breach of this Agreement, xxxx, charge, collect a deposit from, seek compensation or remuneration or reimbursement from, or have any recourse against any Member or any person (other than PacifiCare) acting on behalf on any Member or attempt to do any of the foregoing for Covered Services provided or arranged pursuant to this Agreement. Medical Group and its Participating Providers shall not maintain any action at law or equity against a Member to collect sums owed by PacifiCare to Medical Group. Upon notice of any such action, PacifiCare may terminate this Agreement as provided above and take all other appropriate action consistent with the terms of this Agreement to eliminate such charges, including, without limitation, requiring Medical Group and its Participating Providers to return all sums collected as surcharges from Members or their representatives. For purposes of this Agreement, “Surcharges” are additional fees for Covered Services which are not disclosed to Members in the Subscriber Agreement and/or Evidence of Coverage, are not allowable Copayments and are not authorized by this Agreement. Nothing in this Agreement shall be construed to prevent Medical Group from providing non-Covered Services on a usual and customary fee-for-service basis to Members. Medical Group and its Participating Providers’ obligations under this Section shall survive the termination of this Agreement with respect to Covered Services provided or arranged during or after the term of this Agreement, regardless of the cause giving rise to such termination, and this Section shall be construed to be for the benefit of Members. This Section supersedes any oral or written contrary agreement now existing or hereafter entered into between Medical Group and any Member or a person acting on behalf of any Member. Any modification, additions, or deletions to the provisions of this Section shall be effective only following any required notice to HCFA or other applicable Government Agency.

No Billing of Members (Member Hold Harmless Provision). With the exception of Copayments and charges for non-Covered Services delivered on a fee-for-service basis to Members, Medical Group and its Participating Providers shall in no event, including, without limitation, non-payment by PacifiCare, insolvency of PacifiCare, or breach of this Agreement, xxxx, charge, collect a deposit from, seek compensation or remuneration or reimbursement from, or have any recourse against any Member or any person (other than PacifiCare) acting on behalf on any Member or attempt to do any of the foregoing for Covered Services provided or arranged pursuant to this Agreement. Medical Group and its Participating Providers shall not maintain any action at law or equity against a Member to collect sums owed by PacifiCare to Medical Group. Upon notice of any such action, PacifiCare may terminate this Agreement as provided above and take all other appropriate action consistent with the terms of this Agreement to eliminate such charges, including, without limitation, requiring Medical Group and its Participating Providers to return all sums collected as surcharges from Members or their representatives. For purposes of this Agreement, “Surcharges” are additional fees for Covered Services which are not disclosed to Members in the Subscriber Agreement and/or Evidence of Coverage, are not allowable Copayments and are not authorized by this Agreement. Nothing in this Agreement shall be construed to prevent Medical Group from providing non-Covered Services on a usual and customary fee-for-service basis to Members. Members Medical Group and its Participating Providers’ obligations under this Section shall survive the termination of this Agreement with respect to Covered Services provided or arranged during or after the term of this Agreement, regardless of the cause giving rise to such termination, and this Section shall be construed to be for the benefit of Members. This Section supersedes any oral or written contrary agreement now existing or hereafter entered into between Medical Group and any Member or a person acting on behalf of any Member. Any modification, additions, or deletions to the provisions of this Section shall be effective only following any required notice to HCFA or other applicable Government Agency.