BLUE SHIELD LICENSE AGREEMENT (Includes revisions, if any, adopted by Member Plans through their November 13, 2008 meeting)Blue Shield License Agreement • March 18th, 2009 • Triple-S Management Corp • Accident & health insurance • Illinois
SECTIONS Page Section 1: Definitions 6 Section 2: Eligibility, Enrollment & Disenrollment, Conversion 21 Section 3: Benefit & Services; Fraud & Abuse; Grievance System 37 Section 4: TPA Contracts with HCOs and Participating Providers; Quality of...Contract • March 18th, 2009 • Triple-S Management Corp • Accident & health insurance • Puerto Rico
Si el asegurado está registrado, todos los servicios, procedimientos y medicamentos excepto 99201-99205 y 99212-99215 de los médicos de la IPA del asegurado. Se pagará capitación a la IPA solo por el subfondo del PCP.
