Within California Sample Clauses

Within California. If you are temporarily traveling within California, but are outside of your Primary Care Physician Service Area, if possible you should call Shield Concierge at the number provided on the back page of this booklet for assistance in receiving Ur- gent Services through a Blue Shield of California provider. You may also locate a Blue Shield provider by visiting our web site at ▇▇▇.▇▇▇▇▇▇▇▇▇▇▇▇.▇▇▇. However, you are not re- quired to use a Blue Shield of California provider to receive Urgent Services; you may use any Cali- fornia provider. Out-of-Area Follow-up Care is also covered ately use the “911” emergency response system (where available) or seek immediate care from the nearest Hospital. Members should go to the closest Plan Hospital for Emergency Services whenever possible. The Member should notify their Primary Care Physi- cian within 24 hours of receiving Emergency Ser- vices or as soon as reasonably possible following medical stabilization. through a Blue Shield of California provider or from any California provider. Authorization by Blue Shield is required for more than two Out-of- Area Follow-up Care outpatient visits. Blue Shield may direct the patient to receive the additional fol- low-up services from their Primary Care Physi- cian. If services are not received from a Blue Shield of California provider, you may be required to pay the provider for the entire cost of the service and submit a claim to Blue Shield. Claims for Urgent Services obtained outside of your Primary Care Physician Service Area within California will be reviewed retrospectively for coverage. When you receive covered Urgent Services out- side your Primary Care Physician Service Area
View SourceView Similar (7)
Within California. If you are temporarily traveling within California, but are out- side of your Personal Physician Service Area, if possible you should call Blue Shield Member Services at the number pro- vided on the last page of this booklet for assistance in receiv- ing Urgent Services through a Blue Shield of California Plan Provider. You may also locate a Plan Provider by visiting our web site at ▇▇▇▇://▇▇▇.▇▇▇▇▇▇▇▇▇▇▇▇.▇▇▇. However, you are not required to use a Blue Shield of California Plan Provider to receive Urgent Services; you may use any provider. Note: Authorization by Blue Shield is required for care that involves a surgical or other procedure or inpatient stay. Follow-up care is also covered through a Blue Shield of Cali- fornia Plan Provider and may also be received from any pro- vider. However, when outside your Personal Physician Ser- vice Area authorization by Blue Shield is required for more than two Out-of-Area Follow-up Care outpatient visits. Blue Shield may direct the patient to receive the additional follow- up services from the Personal Physician. If services are not received from a Blue Shield of California Plan Provider, you may be required to pay the provider for the entire cost of the service and submit a claim to Blue Shield. Claims for Urgent Services obtained outside of your Personal Physician Service Area within California will be reviewed retrospectively for coverage. When you receive covered Urgent Services outside your Per- ▇▇▇▇▇ Physician within California, the amount you pay, if not subject to a flat dollar copayment, is calculated on Blue Shield’s Allowed Charges. INTER-PLAN PROGRAMS Blue Shield has a variety of relationships with other Blue Cross and/or Blue Shield Plans and their Licensed Controlled Affiliates (“Licensees”) referred to generally as “Inter-Plan Programs.” Whenever you obtain healthcare services outside of California, the claims for these services may be processed through one of these Inter-Plan Programs. When you access Covered Services outside of California you may obtain care from healthcare providers that have a contrac- tual agreement (i.e., are “participating providers”) with the local Blue Cross and/or Blue Shield Licensee in that other geographic area (“Host Plan”). In some instances, you may obtain care from non-participating healthcare providers. Blue Shield’s payment practices in both instances are described in this booklet. BLUECARD PROGRAM Under the BlueCard Program, when you obtain Covered Ser- vices wit...
View SourceView Similar (5)
Within California. The licenses granted above may be extended to new Designated Facilities within California only with the prior written approval of UNOCAL. Notwithstanding the foregoing, prior written approval of UNOCAL is not required if, after such extension of a license, the total number of NATIONAL Facilities within California does not exceed the total number of NATIONAL Facilities in California as of the Closing Date, provided that such new Designated Facility is not located within one (1) mile of a UNOCAL Facility then in existence, measured along the Interstate Highway or any street, highway or road upon which such UNOCAL Facility is located. Any and all contracts extending NATIONAL's license to use the Marks and/or Service Marks to its Resellers, shall be in writing and in a form which has first been approved by UNOCAL in writing, which approval shall not be unreasonably withheld. UNOCAL shall have the right, at its expense, upon reasonable notice, to inspect and copy all fully signed extensions or contracts. No other right or license, express or implied, is granted under this Agreement by either party hereto for the use of any trademark, service ▇▇▇▇ or trade name.
View Source
Within California. If you are temporarily traveling within California, but are outside of your Personal Physician Service Area, if possible you should call Shield Concierge at the number provided on the back page of this booklet for assistance in receiving Urgent Services through a Blue Shield of California Plan Provider. You may also locate a Plan Provider by visiting our web site at ▇▇▇.▇▇▇▇▇▇▇▇▇▇▇▇.▇▇▇. However, you are not required to use a Blue Shield of California Plan Provider to receive Urgent Services; you may use any provider. Note: Authorization by Blue Shield is required for care that involves a surgical or other procedure or inpatient stay. Follow-up care is also covered through a Blue Shield of California Plan Provider and may also be received from any provider. However, when outside your Personal Physician Service Area authorization by Blue Shield is required for more than two Out-of-Area Follow-up Care outpatient visits. Blue Shield may direct the patient to receive the additional follow-up services from the Personal Physician. If services are not received from a Blue Shield of California Plan Provider, you may be required to pay the provider for the entire cost of the service and submit a claim to Blue Shield. Claims for Urgent Services obtained outside of your Personal Physician Service Area within California will be reviewed retrospectively for coverage. When you receive covered Urgent Services outside your Personal Physician Service Area within California, the amount you pay, if not subject to a flat dollar Copayment, is calculated based on Blue Shield’s Allowed Charges.
View Source

Related to Within California

  • Pursuant to California Franchise Tax Board regulations, County will automatically withhold 7% from all payments made to vendors who are non-residents of California.

  • Agreement Made in California; Venue The formation, interpretation and performance of this Agreement shall be governed by the laws of the State of California. Venue for all litigation relative to the formation, interpretation and performance of this Agreement shall be in San Francisco.

  • Oregon Upon failure of the Obligor to perform under the Agreement, the insurer shall pay on behalf of the Obligor any sums the Obligor is legally obligated to pay and any service that the Obligor is legally obligated to perform. Termination of the reimbursement policy shall not occur until a notice of termination has been mailed or delivered to the Director of the Department of Consumer and Business Services. This notice must be mailed or delivered at least 30 days prior to the date of termination. CANCELLATION section is amended as follows: You, the Service Agreement Holder may apply for reimbursement directly to the insurer if a refund or credit is not paid before the 46th day after the date on which Your Agreement is returned to the provider. ARBITRATION section of this Agreement is removed.

  • Utah This Agreement is subject to limited regulation by the Utah Insurance Department. To file a complaint, contact the Utah Insurance Department. Coverage afforded under this Agreement is not guaranteed by the Utah Property and Casualty Guaranty Association. Proof of loss should be furnished by You to the Administrator as soon as reasonably possible. Failure to furnish such notice or proof within the time required by this Agreement does not invalidate or reduce a claim. CANCELLATION section is amended as follows: We can cancel this Agreement during the first sixty (60) days of the initial annual term by mailing to You a notice of cancellation at least thirty (30) days prior to the effective date of cancellation except that We can also cancel this Agreement during such time period for non-payment of premium by mailing You a notice of cancellation at least ten (10) days prior to the effective date of cancellation. After sixty (60) days have elapsed, We may cancel this Agreement by mailing a cancellation notice to You at least ten (10) days prior to the cancellation date for non-payment of premium and thirty (30) days prior to the cancellation date for any of the following reasons: (a) material misrepresentation, (b) substantial change in the risk assumed, unless the We should reasonably have foreseen the change or contemplated the risk when entering into the Agreement or (c) substantial breaches of contractual duties, conditions, or warranties. The notice of cancellation must be in writing to You at Your last known address and contain all of the following: (1) the Agreement number, (2) the date of notice, (3) the effective date of the cancellation and, (4) a detailed explanation of the reason for cancellation. Any matter in dispute between You and the company may be subject to arbitration as an alternative to court action pursuant to the rules of (the American Arbitration Association or other recognized arbitrator), a copy of which is available on request from the company. Any decision reached by arbitration shall be binding upon both You and the company. The arbitration award may include attorney's fees if allowed by state law and may be entered as a judgment in any court of proper jurisdiction.