Restrictions on Billing. Dual payment/compensation or double billing is prohibited and may not be requested or accepted. For example, if WING receives or is offered state funds for aircraft operating expenses (fuel, oil, maintenance), WING may not seek or accept reimbursement for the same expense from CAP National Headquarters, or from any other source (i.e. another federal agency).
Restrictions on Billing. Provider may not charge Members or Blue Shield more than Provider charges its other insured and uninsured patients. When requested, Provider must substantiate his, her, or its usual charges to Blue Shield. Provider may enter into agreements with a health maintenance organization, preferred provider organization, insurer, third party administrator or similar entity to accept allowances or reimbursement different than Provider routinely receives from Blue Shield. Additionally, a Provider may waive any and all applicable Member cost sharing to benefit a financially disadvantaged patient, provided that documentation supporting such is noted in the provider’s records and is appropriate under the circumstances.
Restrictions on Billing. Professional Provider may not charge Members or Highmark more than Professional Provider charges its other insured and uninsured patients. When requested, Professional Provider must substantiate his, her, or its Usual Charges to Highmark. Professional Provider may enter into agreements with a HMO, PPO, insurer, third party administrator or similar entity to accept allowances or reimbursement different than Professional Provider routinely receives from Highmark or its Usual Charges. Additionally, a Professional Provider may waive any and all applicable Member Cost Sharing to benefit a financially disadvantaged patient, provided that documentation supporting such is noted in the Professional Provider’s records and is appropriate under the circumstances.
Restrictions on Billing. Dual payment/compensation or double billing is prohibited and may not be requested or accepted. For example, if ORWG receives or is offered state funds for aircraft operating expenses (fuel, oil, maintenance), ORWG may not seek or accept reimbursement for the same expense from CAP National Headquarters, or from any other source (i.e. another federal agency).
