Common use of Permitted Billing of Members Clause in Contracts

Permitted Billing of Members. Facility may xxxx or charge Members only in the following circumstances: (a) applicable Copayments, Coinsurance and/or Deductibles, if any, not collected at the time that Covered Services are rendered; and (b) for services that are not Covered Services only if: (i) the Member’s Plan provides and/or Company confirms that the specific services are not covered; (ii) the Member was advised in writing prior to the services being rendered that the specific services may not be Covered Services; and (iii) the Member agreed in writing to pay for such services after being so advised. Facility acknowledges that Company’s denial or adjustment of payment to Facility based on Company’s performance of utilization management as described in Section 4.1.3 or otherwise is not a denial of Covered Services under this Agreement or under the terms of a Plan, except if Company confirms otherwise under this Section 4.3. Facility may xxxx or charge individuals who were not Members at the time that services were rendered.

Permitted Billing of Members. Facility Group may xxxx or charge Members only in the following circumstances: (a) applicable Copayments, Coinsurance and/or Deductibles, if any, not collected at the time that Covered Services are rendered; and (b) for services that are not Covered Services only if: (i) the Member’s Plan provides and/or Company confirms that the specific services are not covered; (ii) the Member was advised in writing prior to the services being rendered that the specific services may not be Covered Services; and (iii) the Member agreed in writing to pay for such services after being so advised. Facility Group acknowledges that Company’s denial or adjustment of payment to Facility Group based on Company’s performance of utilization management as described in Section 4.1.3 4.1.4 or otherwise is not a denial of Covered Services under this Agreement or under the terms of a Plan, except if Company confirms otherwise under this Section 4.34.3.1. Facility Group may xxxx or charge individuals who were not Members at the time that services were rendered.

Permitted Billing of Members. Facility Hospital may xxxx or charge Members only in the following circumstances: (a) applicable Copayments, Coinsurance and/or Deductibles, if any, not collected at the time that Covered Services are rendered; and (b) for services that are not Covered Services only if: (i) the Member’s Plan provides and/or Company confirms that the specific services are not covered; (ii) the Member was advised in writing prior to the services being rendered that the specific services may not be Covered Services; and (iii) the Member agreed in writing to pay for such services after being so advised. Facility Hospital acknowledges that Company’s denial or adjustment of payment to Facility Hospital based on Company’s performance of utilization management as described in Section 4.1.3 or otherwise is not a denial of Covered Services under this Agreement or under the terms of a Plan, except if Company confirms otherwise under this Section 4.3. Facility Hospital may xxxx or charge individuals who were not Members at the time that services were rendered.

Permitted Billing of Members. Facility Provider may xxxx or charge Members only in the following circumstances: (a) applicable Copayments, Coinsurance and/or Deductibles, if any, not collected at the time that Covered Services are rendered; and (b) for services that are not Covered Services only if: (i) the Member’s Plan provides and/or Company confirms that the specific services are not covered; (ii) the Member was advised in writing prior to the services being rendered that the specific services may not be Covered Services; and (iii) the Member agreed in writing to pay for such services after being so advised. Facility Provider acknowledges that Company’s denial or adjustment of payment to Facility Provider based on Company’s performance of utilization management as described in Section 4.1.3 or otherwise is not a denial of Covered Services under this Agreement or under the terms of a Plan, except if Company confirms otherwise under this Section 4.3. Facility Provider may xxxx or charge individuals who were not Members at the time that services were rendered.