Examples of Participating Facility in a sentence
For non-Emergency Services performed by Non-Participating Providers during Your Visit at a Participating Facility, and for Emergency Services provided by a Non-Participating Provider or Non-Participating Emergency Facility, the Recognized Amount is used to calculate Your cost-share requirements, including Deductibles, Copayments, and Coinsurance.
When You receive emergency medicine, anesthesia, pathology, radiology, laboratory, neonatology, assistant surgeon, hospitalist, or intensivist services at a Participating Facility, Non-Participating Providers can’t balance bill You and may not ask You to give up Your protections not to be balance billed.
If any MMCAP Infuse Participating Facility fails to comply with the agreed upon payment terms, Wholesaler will have the right to change the Service Fee Discount to that which the MMCAP Infuse Participating Facility is entitled to prospectively, to reflect that MMCAP Infuse Participating Facility’s actual payment practices.
An MMCAP Infuse Participating Facility will be deemed to have failed to comply with the payment terms if it does not make timely payment for a period lasting two cycles or, with respect to MMCAP Infuse Participating Facilities selecting the 30 Day Pay, 45 Day Pay, or 90 Day Pay for a period of sixty (60) calendar days.
Consultation services when rendered to a Member during an Inpatient Stay in a Participating Facility Provider that is a Hospital, Rehabilitation Hospital or Skilled Nursing Facility by a Referred Specialist at the request of the attending Professional Provider.