Accept Reimbursement Sample Clauses
Accept Reimbursement. Group agrees to accept as payment in full for Covered Services rendered to Blue Choice PPO Members the lesser of Groups Usual Charge or The Plans Maximum Reimbursement Allowance set forth in Article III and hold Blue Choice PPO Members harmless from any sums in excess of this Maximum Reimbursement Allowance. Group may collect from the Blue Choice PPO Member any amounts for Noncovered Services and the applicable copayment and deductible unless prohibited by law. Until The Plan has determined the Maximum Reimbursement Allowance and notified Group as to the amount due from the Blue Choice PPO Member, if any, under the Blue Choice PPO Members Benefit Agreement, Group shall not bill or attempt to collect from the Blue Choice PPO Member any coinsurance amounts. The total amount collected from The Plan, or administered accounts, and the Blue Choice PPO Member for copayment, deductible and coinsurance, but not including Noncovered Services, may not exceed the lesser of Groups Usual Charge or The Plans Maximum Reimbursement Allowance. Group agrees to promptly refund to the Blue Choice PPO Member any amounts which may have been collected from the Blue Choice PPO Member in excess of the Blue Choice PPO Members responsibility as shown on The Plans provider claims summary.
Accept Reimbursement. Group agrees to accept as payment in full for Covered Services rendered to Blue Plan65 Select Members the lesser of Group's Usual Charge or the Medicare Part B allowable charge. Medicare Part B deductible and coinsurance amounts which would ordinarily be owed by the Blue Plan65 Select Member will be paid directly to Group by The Plan on behalf of the Blue Plan65 Select Member. Group shall not bill or attempt to collect any amounts directly from the Blue Plan65 Select Member except for those services not covered by Medicare Part B. The Plan will not reimburse, nor may Group collect from the Blue Plan65 Select Member, any amounts for Professional Services unless such services have been rendered to an identifiable individual patient and are supported by a written report. Group agrees to promptly refund to the Blue Plan65 Select Member any amounts which may have been collected from the Blue Plan65 Select Member in excess of the Blue Plan65 Select Member's responsibility as shown on The Plan's provider claims summary.
Accept Reimbursement. Group agrees to accept as payment in full for Covered Services rendered to Members the lesser of Group's Usual Charge or The Plan's Maximum Reimbursement Allowance set forth in Article V and hold Members harmless from any sums in excess of this Maximum Reimbursement Allowance. Group may collect from the Member any amounts for Noncovered Services and the applicable copayment and deductible unless prohibited by law. Until The Plan has determined the Maximum Reimbursement Allowance and notified Group as to the amount due from the Member, if any, under the Member's Benefit Agreement, Group shall not bill or attempt to collect from the Member any coinsurance amounts. The total amount collected from The Plan, or administered accounts, and the Member for copayment, deductible, and coinsurance, but not including Noncovered Services, may not exceed the lesser of Group's Usual Charge or The Plan's Maximum Reimbursement Allowance. Group agrees to promptly refund to the Member any amounts which may have been collected from the Member in excess of the Member's responsibility as shown on The Plan's provider claims summary.
Accept Reimbursement. Hospital agrees to accept as payment in full the lesser of Hospital’s charges for Covered Services or The Plan’s Maximum Reimbursement Allowance set forth in Article IV of this Blue Plan65 Select Addendum. Hospital agrees to ▇▇▇▇ Member only for Hospital Services not covered by Medicare or the Blue Plan65 Select Benefit Agreement. Hospital shall not ▇▇▇▇ or attempt to collect from Member for Hospital Services denied as not Medically Necessary or Experimental/Investigational/Unproven in accordance with Article VI of the Agreement and Article V of this Blue Plan65 Select Addendum unless Hospital has obtained a Written Waiver from the Blue Plan65 Select Member prior to rendering services. Hospital shall refund to Blue Plan65 Select Member any amounts which may have been collected from the Blue Plan65 Select Member in excess of the Blue Plan65 Select Member’s responsibility as shown on The Plan’s Explanation of Claims Submission when issued.
Accept Reimbursement. Hospital agrees to accept as payment in full the lesser of Hospital’s charges for Covered Services or The Plan’s Maximum Reimbursement Allowance set forth in Article IV of this Blue Plan65 Select Addendum. Hospital agrees to ▇▇▇▇ Member only for Hospital Services not covered by Medicare or the Blue Plan65 Select Benefit Agreement. Hospital shall not ▇▇▇▇ or attempt to collect from Member for Hospital Services denied as not Medically Necessary or Experimental/Investigational/Unproven in accordance with Article VI of the Agreement and Article V of this Blue Plan65 Select Addendum unless Hospital has obtained a Written Waiver from the Blue Plan65 Select Member prior to rendering services. Hospital shall refund to Blue Plan65 Select Member any amounts which may have been collected from the Blue Plan65 Select Member in excess of the Blue Plan65 Select Member’s responsibility as shown on The Plan’s Explanation of Claims Submission when issued.