Common use of Non-Covered Services Clause in Contracts

Non-Covered Services. Before a Provider provides items or services to a Member that are not Covered Services, Provider shall (a) inform the Member of the specific items or services that are not Covered Services and that they will not be paid for by Health Plan, and (b) obtain the Member’s written agreement to pay for such specific items or services after being so advised. Provider may contact Health Plan to determine if an item or service is a Covered Service.

Non-Covered Services. Before Every time a Provider provides items or services to a Member that are not Covered Services, before providing the items or services the Provider shall (a) inform the Member of the specific items or services that are not Covered Services and that they will not be paid for by Health Plan, and (b) obtain the Member’s written agreement to pay for such specific items or services after being so advised. Provider may shall contact Health Plan to determine for a coverage determination in any case where Provider is unsure if an item or service is a Covered Service.