Payment of Claims - Covered Medical Services Sample Clauses

Payment of Claims - Covered Medical Services. Payment for Covered Services rendered by a Preferred Provider will be paid directly to the Preferred Provider rendering the services. Direct payments will also be made by CareFirst to providers from the United States Department of Defense and the United States Department of Veteran Affairs. If a Member makes an Assignment of Benefits for services rendered by a Non-Preferred Provider who is a physician, a Hospital-Based Physician, an On-Call Physician, or an Ambulance Service Provider, payment for services will be paid directly to the Non- Preferred Provider who is a physician, a Hospital-Based Physician, an On-Call Physician or an Ambulance Service Provider except as provided in Section 6.3C. If a Member receives Covered Services from any other provider other than a Non-Preferred Provider who is a physician, a Hospital-Based Physician, an On-Call Physician or an Ambulance Service Provider who accepts an Assignment of Benefits, CareFirst reserves the right to pay either the Member or the provider. It is the Member's responsibility to apply any CareFirst payments received to the claim from the Non-Preferred Provider. In any event, the Member is responsible for any applicable Deductible, Copayment or Coinsurance amounts stated in the Schedule of Benefits and, unless the fee is negotiated, for any Balance Xxxx from a Non-Preferred Provider who is not a Hospital-Based Physician, an On-Call Physician, or an Ambulance Service Provider who accepts an Assignment of Benefits.