Common use of Nonaffiliated Clause in Contracts

Nonaffiliated. Practitioners - Provider shall ensure that Covered Services are provided only by Practitioners that have been accepted by Health Plan as Affiliated Providers. In the event that Covered Services are inadvertently provided by a nonaffiliated Practitioner, Provider shall bill Health Plan directly and accept applicable Health Plan payment rates as payment in full. Notwithstanding the above, medical services provided by any nonaffiliated Practitioner that has failed Health Plan credentials or quality review or has been excluded or debarred from Medicare shall not be payable. All Covered Services provided by nonaffiliated Practitioners are subject to Member Hold Harmless provisions herein.

Nonaffiliated. Practitioners - Provider shall ensure that Covered Services are provided only by Practitioners that have been accepted by Health Plan as Affiliated Providers. In the event that Covered Services are inadvertently provided by a nonaffiliated Practitioner, Provider shall bill xxxx Health Plan directly and accept applicable Health Plan payment rates as payment in full. Notwithstanding the above, medical services provided by any nonaffiliated Practitioner that has failed Health Plan credentials or quality review or has been excluded or debarred from Medicare shall not be payable. All Covered Services provided by nonaffiliated Practitioners are subject to Member Hold Harmless provisions herein.