Arranging for Benefits. Except for Emergency Services and Out-of-Area Urgent Care Services, each Member must obtain all Benefits from or through the Plan Providers specified in Sections 2.4 and 2.5, below. Additionally, except for Emergency Services and Out-of-Area Urgent Care Services, each Member is responsible for obtaining all necessary Authorization for Benefits. Except for Emergency Services and Out-of-Area Urgent Care Services, if Benefits are not provided by the Plan Providers specified in Sections 2.4 and 2.5, or if Benefits are provided without the necessary Authorization, the Member shall be responsible to pay for such Benefits.
Appears in 5 contracts
Samples: Sharp Health Plan Group Agreement, Sharp Health Plan Group Agreement, Sharp Health Plan Group Agreement
Arranging for Benefits. Except for Emergency Services and Out-of-Out of Area Urgent Care Services, each Member must obtain all Benefits from or through the Plan Providers specified in Sections 2.4 and 2.5, below. Additionally, except for Emergency Services and Out-of-Out of Area Urgent Care Services, each Member is responsible for obtaining all necessary Authorization for Benefits. Except for Emergency Services and Out-of-Out of Area Urgent Care Services, if Benefits are not provided by the Plan Providers specified in Sections 2.4 and 2.5, below, or if Benefits are provided without the necessary Authorization, the Member shall be responsible to pay for such Benefits.
Appears in 1 contract
Samples: Sharp Health Plan Group Agreement
