Common use of Non-Affiliated Providers Clause in Contracts

Non-Affiliated Providers. It is understood that in some instances Enrollees will require specialty care not available from an Affiliated Provider and that Contractor will arrange that such services be provided by a non-Affiliated Provider. In such event, Contractor will promptly negotiate an agreement (“Single Case Agreement”) with a non-Affiliated Provider to treat the Enrollee until a qualified Affiliated Provider is available. Contractor shall make best efforts to have any non-Affiliated Provider billing for services rendered in Illinois be enrolled in the HFS Medical Program prior to paying a claim.

Non-Affiliated Providers. It is understood that in some instances Enrollees will require specialty care not available from an Affiliated Provider and that Contractor will arrange that such services be provided by a non-Affiliated Provider. In such event, Contractor will promptly negotiate an agreement (“Single ―Single Case Agreement”Agreement‖) with a non-Affiliated Provider to treat the Enrollee until a qualified Affiliated Provider is available. Contractor shall make best efforts to have any non-Affiliated Provider billing for services rendered in Illinois be enrolled in the HFS Medical Program prior to paying a claim.