IN NETWORK. If my treating dentist is in-network with my dental insurance plan, I will be billed pursuant to the terms of my insurance policy and my dentist’s contract with the insurer. Even when the practice and my treating dentist are a participating provider with my insurance, I understand that the practice may hold me responsible and collect all charges in any one of the following situations: ● When I choose to have a service that my dental plan covers but I do not obtain the required referral or prior authorization from my health plan. ● When I choose not to use my dental plan and agree to pay for services myself. ● When I receive services that are not covered under my dental plan
IN NETWORK. Premium is the Commercial Plan Premium, as defined in Product Attachment A, billed or accounted for by PacifiCare for coverage of In-Network Services under the PacifiCare Commercial POS Plan.
IN NETWORK. United Health Care participating providers accept fees as payment in full and agree not to xxxx members for any remaining balances. Members are responsible only for stated co- payments. No claim forms are required to be completed by plan members. Out of Network: Benefits are paid using Reasonable and Customary (R&C) guidelines. R&C refers to charges or fees of a physician which are frequently determined by set services offered over a period of time within a specific geographic area. Fees charged by non- participating providers in excess of R&C limits will be the employee's responsibility and do not help satisfy out-of-pocket limits or deductibles. Any claim form required to be filed will be the plan participant's responsibility. This Benefit Summary is intended to be a brief description of health care benefits available for employees and eligible dependents. More detail is provided in your plan booklet.
IN NETWORK. Medical Provider An in-network medical provider is one contracted with the insured person’s policy to provide services to policy members for specific pre-negotiated rates.
IN NETWORK. You can maximize your benefits and minimize your costs and paperwork when care is delivered by a participating provider. Simply present your membership card and pay any applicable cost-share(s). Participating providers will submit claims directly to Anthem Blue Cross and Blue Shield of Connecticut on your behalf.
IN NETWORK. PREMIUM is the Commercial Plan Premium, as defined in Product Attachment A, billed or accounted for by PacifiCare for coverage of In-Network Services under the PacifiCare Commercial POS Plan.
IN NETWORK. A planned material change in Network operations cannot be made by I@I without the prior written consent of the Governing Body. A "material change" includes, but is not limited to, a change which increases response time to inquiries, adds to the complexity of system use, diminishes services provided to users, or results in a comparable impact on operations noticeable by users. I@I will provide to the Governing Body at least thirty (30) days, prior written notice of a planned material change in Network operations.
IN NETWORK. When You receive In-Network Covered Services, You are responsible only for the applicable Copayment, Deductible, and/or Coinsurance amounts noted in Your Schedule of Benefits, Covered Services, and Exclusions. For the most up-to-date Provider information, you may contact the CHL Customer Service Department or access Our website at xxx.xxxxxxxxx.xxx. Out-of-Network. Services rendered by Non-Participating Providers are not covered, except for the following: Emergency Services Urgent Care provided outside the Service Area Services Authorized in advance by CHL If You receive Covered Services from a Non-Participating Provider, You are responsible for the Copayment, Deductible, and/or Coinsurance amounts noted in Your Schedule of Benefits, Covered Services, and Exclusions, plus any amount in excess of the Out-of-Network Rate (“ONR”). Please see Section 1.8 for more information on the Out-of Network Rate.
IN NETWORK. The term “In-Network” is defined as the use of a covered primary care provider or other covered provider who participate in the network such that all claims incurred by such a provider will be processed under the “In-Network” benefit level as described in the applicable Schedule of Benefits. Blue Choice New England Plan 2 uses the term “pcp/plan approved benefits” in a manner similar to in- network.
