Common use of Verification of Eligibility Clause in Contracts

Verification of Eligibility. Crescent will contractually require each TPA or Plan to agree to provide a mechanism for Facility to verify a patient's eligibility as a Member, based on current information held by Payor or Payor’s designee prior to rendering services. Unless otherwise directed by Xxxxx or TPA, Facility may verify the current status of the Member’s eligibility for Covered Services by requesting the Member to present his or her identification card or by contacting Payor or Xxxxx’s designee during normal business hours. So long as Facility substantially complies with such mechanisms, Crescent shall facilitate discussion of mutually agreeable provisions that may be made for cases where incorrect or retroactive information was submitted by employer groups. In addition, Crescent will contractually require Payor not to discontinue coverage for a Member during a confined hospital stay to the extent previously authorized by Payor and consistent with concurrent review procedures. Notwithstanding the foregoing, Facility shall not be required to verify coverage prior to rendering services in an Emergency, and Crescent will use best commercial efforts to require Payors to contractually agree that Facility shall not be denied payment for services rendered in an emergency solely due to Facility’s failure to verify coverage in advance of rendering services. Crescent shall require Payor to contractually agree that Facility shall not be liable to Payor for any refusal or failure to render services to any person for whom coverage cannot be verified in accordance with Payor's customary administrative procedures.

Verification of Eligibility. Crescent will contractually require each TPA or Plan to agree to provide a mechanism for Facility Provider to verify a patient's ’s eligibility as a Member, based on current information held by Payor or Payor’s designee prior to rendering services. Unless otherwise directed by Xxxxx or TPA, Facility Provider may verify the current status of the Member’s eligibility for Covered Services by requesting the Member to present his or her identification card or by contacting Payor or Xxxxx’s designee during normal business hours. So long as Facility Provider substantially complies with such mechanisms, Crescent shall facilitate discussion of mutually agreeable provisions that may be made for cases where incorrect or retroactive information was submitted by employer groups. In addition, Crescent will contractually require Payor not to discontinue coverage for a Member during a confined hospital stay to the extent previously authorized by Payor and consistent with concurrent review procedures. Notwithstanding the foregoing, Facility Provider shall not be required to verify coverage prior to rendering services in an Emergency, and Crescent will use best commercial efforts to require Payors to contractually agree that Facility Provider shall not be denied payment for services rendered in an emergency solely due to FacilityProvider’s failure to verify coverage in advance of rendering services. Crescent shall require Payor to contractually agree that Facility Provider shall not be liable to Payor for any refusal or failure to render services to any person for whom coverage cannot be verified in accordance with Payor's ’s customary administrative procedures.

Verification of Eligibility. Crescent will contractually require each TPA or Plan to agree to provide a mechanism for Facility Physician to verify a patient's ’s eligibility as a Member, based on current information held by Payor or Payor’s designee prior to rendering services. Unless otherwise directed by Xxxxx or TPA, Facility Physician may verify the current status of the Member’s eligibility for Covered Services by requesting the Member to present his or her identification card or by contacting Payor or XxxxxPayor’s designee during normal business hours. So long as Facility Physician substantially complies with such mechanisms, Crescent shall facilitate discussion of mutually agreeable provisions that may be made for cases where incorrect or retroactive information was submitted by employer groups. In addition, Crescent will contractually require Payor not to discontinue coverage for a Member during a confined hospital stay to the extent previously authorized by Payor and consistent with concurrent review procedures. Notwithstanding the foregoing, Facility Physician shall not be required to verify coverage prior to rendering services in an Emergency, and Crescent will use best commercial efforts to require Payors to contractually agree that Facility Physician shall not be denied payment for services rendered in an emergency solely due to FacilityPhysician’s failure to verify coverage in advance of rendering services. Crescent shall require Payor to contractually agree that Facility Physician shall not be liable to Payor for any refusal or failure to render services to any person for whom coverage cannot be verified in accordance with Payor's ’s customary administrative procedures.