Payment of claims for Covered Services. Xxxxx will pay claims for Covered Services as further described in the applicable Payment Appendix to this Agreement and in accordance with Payment Policies. Claims for Covered Services subject to coordination of benefits will be paid in accordance with the Customer’s Benefit Plan and applicable state and federal law. The obligation for payment under this Agreement is solely that of Payer, and not that of United unless United is the Payer.
Payment of claims for Covered Services. Xxxxx will pay claims for Covered Services rendered by Participating Professionals according to the least of i) the contract rates in the applicable Payment Appendix, ii) the Participating Professional’s Customary Charge, or iii) as otherwise described in the Payment Appendix. Payment will be subject to Payment Policies. Claims for Covered Services subject to coordination of benefits will be paid in accordance with the Customer’s Benefit Plan and applicable law. The obligation for payment under this Agreement is solely that of Payer, and not that of United unless United is the Payer. Ordinarily, fee amounts listed in the Payment Appendix(ices) for Participating Professionals are based upon primary fee sources. United reserves the right to use gap-fill fee sources where primary fee sources are not available. United routinely updates its payment appendices for Participating Professionals: (a) to remain current with applicable coding practices; (b) in response to price changes for immunizations and injectable medications; and (c) to remain in compliance with HIPAA requirements. United will not attempt to communicate routine updates of this nature. Ordinarily, United’s fee schedule is updated using similar methodologies for similar services. United will give Participating Professionals at least 90 days written or electronic notice of non- routine fee schedule changes which will substantially alter the overall methodology or reimbursement level of the fee schedule. In the event such changes will reduce a Participating Professional’s overall reimbursement under this Agreement, the Participating Professional may terminate his or her participation in United’s network by giving 60 days written notice to United, provided that the notice is given within 30 days after United’s notice of the fee schedule change.
Payment of claims for Covered Services. Payer will pay claims for Covered Services according to the amount specified in the applicable Payment Appendix(ices) to this Agreement and in accordance with Payment Policies. Claims for Covered Services subject to coordination of benefits will be paid in accordance with the Customer’s Benefit Plan and applicable law. The obligation for payment under this Agreement is solely that of Payer and not that of United unless United is the Payer.
Payment of claims for Covered Services. Payer will pay claims for Covered Services according to the least of the contract rates in the applicable Payment Appendix, the Medical Group’s Customary Charge or as otherwise described in the Payment Appendix, and in accordance with Payment Policies. Claims for Covered Services subject to coordination of benefits will be paid in accordance with the Customer’s Benefit Plan and applicable law. The obligation for payment under this Agreement is solely that of Payer and not that of United unless United is the Payer. Ordinarily, fee amounts listed in the Payment Appendix(ices) are based upon primary fee sources. United reserves the right to use gap-fill fee sources where primary fee sources are not available. United routinely updates its payment appendices: (1) to remain current with applicable coding practices; (2) in response to price changes for immunizations and injectable medications; and (3) to remain in compliance with HIPAA requirements. United will not attempt to communicate routine updates of this nature. Ordinarily, United’s fee schedule is updated using similar methodologies for similar services. United will give Medical Group at least 90 days written or electronic notice of non-routine fee schedule changes which will substantially alter the overall methodology or reimbursement level of the fee schedule. In the event such changes will reduce Medical Group’s overall reimbursement under this Agreement, Medical Group may terminate this Agreement by giving 60 days written notice to United, provided that the notice is given by Medical Group within 30 days after the notice of the fee schedule change.
Payment of claims for Covered Services. Payer will pay claims for Covered Services according to the amount specified in the applicable Payment Appendix(ices) to this Agreement, and in accordance with Payment Policies. Claims for Covered Services subject to coordination of benefits will be paid in accordance with the Customer’s Benefit Plan and applicable law. The obligation for payment under this Agreement is solely that of Payer and not that of United unless United is the Payer. Ordinarily, fee amounts listed in the Payment Appendix(ices) are based upon primary fee sources. United reserves the right to use gap-fill fee sources where primary fee sources are not available. United routinely updates its payment appendices: (1) to remain current with applicable coding practices; (2) in response to price changes for immunizations and injectable medications; and (3) to remain in compliance with HIPAA requirements. United will not attempt to communicate routine updates of this nature. Ordinarily, United’s fee schedule is updated using similar methodologies for similar services. United will give Facility at least 90 days written or electronic notice of non-routine fee schedule changes which will substantially alter the overall methodology or reimbursement level of the fee schedule. In the event such changes will reduce Facility’s overall reimbursement under this Agreement, Facility may terminate this Agreement by giving 60 days written notice to United, provided that the notice is given by Facility within 30 days after the notice of the fee schedule change.
