Member cost definition
Examples of Member cost in a sentence
Where a reference benefit limit exceeds either a negotiated price or a provider’s billed charge, the Enrolled Member will incur no additional liability, other than any applicable Enrolled Member cost sharing.
Members shall also remain liable for Member cost sharing and other required contributions to coverage for any period of time the Group Agreement is in force during the Grace Period.
The Parties recognize that as a conduit, the Consortium does not incur nor does it allocate any indirect costs of its own to the Consortium Member cost directly incurred pursuant to this Agreement.
Costs incurred for a particular Project pursuant to a Project Contract shall be recovered directly from the Member(s) that participate in a particular Project or pursuant to the Project Contract that governs Member cost responsibility for the Project.
The amendment may include an increase or decrease in Premiums and benefits (including Member cost sharing and the Medicare Part D initial and catastrophic coverage levels).
Costs incurred for a particular Project pursuant to a Project Contract will be recovered pursuant to the Project Contract that governs Member cost responsibility for the Project.
Physician shall collect directly from Member cost share amounts applicable to the Covered Services provided and shall not waive, discount or rebate any such Cost Share payments.
During the applicable suspension period, Velovita products and services may be purchased by the suspended Member at Member cost.
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.
Health Options may utilize Participating Provider’s performance data for activities including, but not limited to, quality improvement activities, public reporting to consumers and/or transparency activities, preferred status designations in the network (tiering) for narrow network activities, reduced Member cost sharing activities, and/or any other activity of or relating to Health Options’ compliance with the accreditation standards of the NCQA.