Common use of Open Clinical Dialogue Clause in Contracts

Open Clinical Dialogue. Nothing contained herein shall be construed to limit, prohibit or otherwise preclude PROVIDER from engaging in open clinical dialogue with any Member(s) or any designated representative of a Member(s) regarding: (a) any Medically Necessary or Medically Appropriate care, within the scope of PROVIDER’s practice, including but not limited to, the discussion of all possible and/or applicable treatments, including information regarding the nature of treatment, risks of treatment, alternative treatments or the availability of alternative treatments or consultations and diagnostic test, and regardless of benefit coverage limitations under the terms of the Plan(s)’ documents or medical policy determinations and whether such treatments are Covered Services under the applicable XXXXX benefit program designs; or (b) the process XXXXX uses on its own behalf or on behalf of Plan(s) to deny payment for a vision care service; or

Open Clinical Dialogue. Nothing contained herein shall be construed to limit, prohibit or otherwise preclude PROVIDER from engaging in open clinical dialogue with any Member(s) Members or any designated representative of a Member(s) ), regarding: (a) any Medically Necessary or Medically Appropriate care, within the scope of PROVIDER’s practice, including but not limited to, the discussion of all possible and/or applicable treatments, including information regarding the nature of treatment, risks of treatment, alternative treatments or the availability of alternative treatments or consultations and diagnostic testtests, and regardless of benefit coverage limitations under the terms of the Plan(s)’ documents or medical policy determinations and whether such treatments are Covered Services under the applicable XXXXX benefit program plan designs; or (b) the process XXXXX uses on its own behalf or on behalf of Plan(s) to deny payment for a vision care service; or