Common use of Balance Billing Clause in Contracts

Balance Billing. In-Network Providers are prohibited from balance billing. In-Network Providers have signed an agreement to accept a predetermined allowed amount for Covered Services rendered to a Member. A Member is not liable for fees in excess of the allowed amount for a Covered Service, except what is due under the Contract, e.g., Copayments, Deductibles or Coinsurance. Out-of-Network Providers are not under an agreement with Alliant and may bill you for fees in excess of the MAC. Non-Covered Services are the sole responsibility of the Member when received from any Provider regardless of network status. Whenever the benefits under any other plan are payable without regard to benefits payable under this plan, this plan determines its order of benefits using the first of the following rules that apply. Services that are not eligible for benefits under both plans will not be subject to coordination of benefits.

Balance Billing. In-Network Providers are prohibited from balance billing. In-Network Providers have signed an agreement to accept a predetermined allowed amount for Covered Services rendered to a Member. A Member is not liable for fees in excess of the allowed amount for a Covered Service, except what is due under the Contract, e.g., Copayments, Deductibles or Coinsurance. Out-of-Network Providers are not under an agreement with Alliant and may bill you You for fees in excess of the MAC. Non-Covered Services are the sole responsibility of the Member when received from any Provider regardless of network status. Whenever the benefits under any other plan are payable without regard to benefits payable under this plan, this plan determines its order of benefits using the first of the following rules that apply. Services that are not eligible for benefits under both plans will not be subject to coordination of benefits.