Out-of-Network Hospital Transfers Sample Clauses

Out-of-Network Hospital Transfers. The MCO must pay an enrollee’s existing out-of-network hospital fees for Medically Necessary covered emergency services until the enrollee’s records, clinical information and care can be transferred to a network hospital, or until such time as the enrollee is no longer enrolled in that MCO, whichever is shorter. The MCO must accept the out-of-network hospital physician or provider’s binding determination of when the enrollee is sufficiently stabilized for transfer or discharge.
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