Qualified Medical Child Support Order (QMCSO). If a court has ordered coverage to be provided by you for a minor child who is an eligible dependent, you must submit to us any required application or enrollment forms including a copy of the court order, along with any additional Premium due. The Effective Date of coverage for the eligible dependent properly enrolled will be the date of the order. You must pay the additional Premium for coverage to be provided for the eligible dependent.
Qualified Medical Child Support Order (QMCSO). In the event an eligible dependent child does not reside with the Subscriber, coverage will be extended when the Subscriber is obligated by QMCSO to provide medical care. You (or your beneficiaries) may obtain, without charge, copies of the Plan’s procedures governing QMCSOs and a sample QMCSO by contacting the Plan Administrator.
Qualified Medical Child Support Order (QMCSO). A child support order from a court of competent jurisdiction or state child care agency, which requires the plan to pro- vide coverage for a dependent child or mem- ber if the plan normally provides coverage for dependent children.
Qualified Medical Child Support Order (QMCSO). A medical child support order that:
Qualified Medical Child Support Order (QMCSO). If you have a dependent child and your employer receives a Medical Child Support Order recognizing the child’s right to enroll in this benefit plan, your employer will promptly notify both you and the dependent that the order has been received. Your employer also will inform you and the dependent of the employer’s procedures for determining whether the order is a Qualified Medical Child support Order. Within a reasonable time after receiving the order, your employer will decide whether the court order is a qualified Medical Child Support Order and will notify you and the dependent of that determination.
Qualified Medical Child Support Order (QMCSO). Beneficiary Members and Family Members can obtain, without charge, a copy of the procedures governing Qualified Medical Child Support Order (QMCSO) determinations from Blue Cross and Blue Shield of Montana.
Qualified Medical Child Support Order (QMCSO). A QMCSO creates or recognizes a right of a child who is recognized under the order as having the right to be enrolled under the health benefit plan to receive benefits for which the Employee is entitled under the plan; and includes the name and last known address of the Employee and each such child, a reasonable description of the type of coverage to be provided by the plan, the period for which coverage must be provided and each plan to which the order applies. Reasonable and/or Reasonableness Shall mean in Alliant’s discretion, services or supplies, which are necessary for the care and treatment of illness or injury not caused by the treating Provider. Determination that a service(s) is reasonable will be made by Alliant, taking into consideration unusual circumstances or complications requiring additional time, skill and experience in connection with a particular service or supply; industry standards and practices as they relate to similar scenarios; and the cause of injury or illness necessitating the service(s). This determination will consider, but will not be limited to, the findings and assessments of the following entities: (a) The National Medical Associations, Societies, and organizations; and (b) The Food and Drug Administration. To be Reasonable, service(s) and/or fee(s) must follow generally accepted billing practices for unbundling or multiple procedures. Services, supplies, care and/or treatment that results from errors in medical care that are clearly identifiable, preventable, and serious in their consequence for patients, are not Reasonable. Alliant retains discretionary authority to determine whether service(s) and/or fee(s) are Reasonable based upon information presented to Alliant. A finding of Provider negligence and/or malpractice is not required for service(s) and/or fee(s) to be considered not Reasonable. Charge(s) and/or services are not considered to be Reasonable, and as such are not eligible for payment, when they result from Provider error(s) and/or facility-acquired conditions deemed “reasonably preventable” through the use of evidence-based guidelines, taking into consideration but not limited to CMS guidelines. Alliant reserves for itself and parties acting on its behalf the right to review charges processed and/or paid by Alliant, to identify charge(s) and/or service(s) that are not Reasonable and therefore not eligible for payment by Alliant under the Contract.” Referral Specific instructions from a Member’s Physician, i...
