Continuation of Care. We shall provide written notice to each [Member] at least 30 business days prior to the termination or withdrawal from Our Provider Network of a [Member’s] PCP and any other Provider from which the [Member] is currently receiving a course of treatment, as reported to Us. The 30-day prior notice may be waived in cases of immediate termination of a health care professional based on a breach of contract by the health care professional, a determination of fraud, or where Our medical director is of the opinion that the health care professional is an imminent danger to the patient or the public health, safety or welfare. We shall assure continued coverage of covered services at the contract rate by a terminated health care professional for up to four months in cases where it is Medically Necessary and Appropriate for the [Member] to continue treatment with the terminated health care professional and in certain cases of active treatment for up to 90 days, as described below. In case of a [Member] in active treatment for a health condition for which the Provider attests that discontinuing care by the Provider would worsen the [Member’s] condition or interfere with anticipated outcomes, coverage of the terminated Provider shall continue for the duration of the treatment, or up to 90 days, whichever occurs first.. In case of pregnancy of a [Member], coverage of services for the terminated health care professional shall continue to the postpartum evaluation of the [Member], up to six weeks after the delivery. With respect to pregnancy, Medical Necessity and Appropriateness shall be deemed to have been demonstrated. For a [Member] who is receiving post-operative follow-up care, We shall continue to cover the services rendered by the health care professional for the duration of the treatment or for up to six months, whichever occurs first. For a [Member] who is receiving oncological treatment or psychiatric treatment, We shall continue to cover services rendered by the health care professional for the duration of the treatment or for up to 12 months, whichever occurs first. For a [Member] receiving the above services in an acute care Facility, We will continue to provide coverage for services rendered by the health care professional regardless of whether the acute care Facility is under contract or agreement with Us. Services shall be provided to the same extent as provided while the health care professional was employed by or under contact with Us. Reimbursement for s...
Continuation of Care. We shall provide written notice to each [Member] at least 30 business days prior to the termination or withdrawal from Our Provider Network of a [Member’s] PCP and any other Provider from which the [Member] is currently receiving a course of treatment, as reported to Us. The 30-day prior notice may be waived in cases of immediate termination of a health care professional based on a breach of contract by the health care professional, a determination of fraud, or where Our medical director is of the opinion that the health care professional is an imminent danger to the patient or the public health, safety or welfare. We shall assure continued coverage of covered services at the contract rate by a terminated health care professional for up to four months in cases where it is Medically Necessary and Appropriate for the [Member] to continue treatment with the terminated health care professional. In case of pregnancy of a [Member], coverage of services for the terminated health care professional shall continue to the postpartum evaluation of the [Member], up to six weeks after the delivery. With respect to pregnancy, Medical Necessity and Appropriateness shall be deemed to have been demonstrated.
Continuation of Care. If Provider is rendering services to Member upon execution of the Agreement, Provider agrees to submit existing treatment plans to Avesis. At no time following execution of this Agreement shall Provider be required to continue treatment of a Member with whom Provider cannot maintain a professional relationship or whose treatment is beyond the scope of Provider’s ability. Provider must work with Avesis and/or Sponsor to transition care for Member. Provider agrees to complete any treatment in progress for a newly enrolled Member. Avesis agrees to negotiate fees in good faith for such treatment.
Continuation of Care. (a) If Payor becomes insolvent, Participating Provider shall provide services for the duration of the period after Xxxxx's insolvency for which premium payment has been made, for Enrollees confined on the date of insolvency in an inpatient facility, and for pregnant Enrollees, until Enrollee's discharge from inpatient facilities, Enrollee's delivery and discharge if pregnant, and/or expiration of benefits under the Coverage Agreement. (OKLA. STAT. XXX. tit. 36, § 6913.E.2; OKLA. ADMIN. CODE 365:40-5-72(b))
Continuation of Care. We shall provide written notice to each Member at least 30 business days prior to the termination or withdrawal from Our Provider Network of a Member’s PCP and any other Provider from which the Member is currently receiving a course of treatment, as reported to Us. The 30-day prior notice may be waived in cases of immediate termination of a health care professional based on a breach of contract by the health care professional, a determination of fraud, or where Our medical director is of the opinion that the health care professional is an imminent danger to the patient or the public health, safety or welfare. We shall assure continued coverage of covered services at the contract rate by a terminated health care professional for up to four months in cases where it is Medically Necessary and Appropriate for the Member to continue treatment with the terminated health care professional and in certain cases of active treatment for up to 90 days, as described below. In case of a Member in active treatment for a health condition for which the Provider attests that discontinuing care by the Provider would worsen the Member’s condition or interfere with anticipated outcomes, coverage of the terminated Provider shall continue for the duration of the treatment, or up to 90 days, whichever occurs first. In case of pregnancy of a Member, coverage of services for the terminated health care professional shall continue to the postpartum evaluation of the Member up to six weeks after the delivery. With respect to pregnancy, Medical Necessity and Appropriateness shall be deemed to have been demonstrated. For a Member who is receiving post-operative follow-up care, We shall continue to cover the services rendered by the health care professional for the duration of the treatment or for up to six months, whichever occurs first. For a Member who is receiving oncological treatment or psychiatric treatment, We shall continue to cover services rendered by the health care professional for the duration of the treatment or for up to 12 months, whichever occurs first. For a Member receiving the above services in an acute care Facility, We will continue to provide coverage for services rendered by the health care professional regardless of whether the acute care Facility is under contract or agreement with Us. Services shall be provided to the same extent as provided while the health care professional was employed by or under contact with Us. Reimbursement for services shall be pursuan...
Continuation of Care. Unless otherwise set forth in this Agreement or required by applicable law or regulation, Company shall, upon termination of this Agreement (for any reason other than those set forth in Section 10.2.3(b)), continue to provide Testing Services to any Member who has, as of the date of termination, provided a specimen for a PreTRM® test. Company shall be reimbursed for such Testing Services pursuant to the terms and conditions of this Agreement.
Continuation of Care. We shall provide written notice to each [Member] at least 30 business days prior to the termination or withdrawal from Our Provider Network of a [Member’s] PCP and any other Provider from which the [Member] is currently receiving a course of treatment, as reported to Us. The 30-day prior notice may be waived in cases of immediate termination of a health care professional based on a breach of contract by the health care professional, a determination of fraud, or where Our medical director is of the opinion that the health care professional is an imminent danger to the patient or the public health, safety or welfare. We shall assure continued coverage of covered services at the contract rate by a terminated health care professional for up to four months in cases where it is Medically Necessary and Appropriate for the [Member] to continue treatment with the terminated health care professional and in certain cases of active treatment for up to 90 days, as described below. In case of a [Member] in active treatment for a health condition for which the Provider attests that discontinuing care by the Provider would worsen the [Member’s] condition or interfere with anticipated outcomes, coverage of the terminated Provider shall continue for the duration of the treatment, or up to 90 days, whichever occurs first.. In case of pregnancy of a [Member], coverage of services for the terminated health care professional shall continue to the postpartum evaluation of the [Member], up to six weeks after the delivery. With respect to pregnancy, Medical Necessity and Appropriateness shall be deemed to have been demonstrated.
Continuation of Care. Provider agrees to complete any treatment in progress for continuation of care cases and cases in mid-treatment for a newly enrolled Member. DentaQuest agrees to negotiate fees in good faith for partial cases/treatment.
Continuation of Care. In the event this Agreement terminates for any reason other than an immediate termination related to Dentist’s licensure status, Dentist agrees to complete any services initiated prior to such termination for Covered Persons, whether Covered Services, non-Covered Services and services not subject to reimbursement by Ameritas, as the case may be, and Dentist agrees to accept payment for such services in accordance with the terms and conditions of both the Covered Person’s particular plan as well as this terminated Agreement for a period of sixty (60) days following the termination date of this Agreement.
Continuation of Care. Group agrees to include language in its Agreement with Physicians/Providers that requires that Physicians/Providers provide continued care for six (6) months or until Member's care is transitioned to a Participating Provider if the Group terminates this Agreement or is terminated by Plan if the Member has a life-threatening condition, or a disabling and degenerative condition. Regardless of the trimester of pregnancy, care for pregnant Members must be continued through the completion of postpartum care. The services must be provided in accordance with the terms of this Agreement. Reimbursement for services provided under these circumstances shall be on a fee-for-service basis at 100% of Medicare's Prevailing Rates.
