Copayments and Deductibles Sample Clauses

Copayments and Deductibles. Except in cases of extreme financial hardship that are documented in the Member’s medical record or where reasonable collection efforts have failed, Provider shall collect all applicable Copayments and Deductibles, including Medicare Copayments and Deductibles, which are the Member’s responsibility.
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Copayments and Deductibles. Physician understands and agrees that the Payer (or, if applicable, IPA) has no responsibility to pay any amount except as described in Paragraph 5.1 above and Physician shall xxxx and attempt to collect copayments, deductibles, and any other fees which are the Covered Person’s responsibility under such Covered Person’s health benefit plan or policy. For medical services not covered by this Agreement and for so long as not prohibited by IPA and/or Payer, Physician may xxxx a Covered Person or other responsible party at a mutually-agreeable charge. Physician agrees to notify the Covered Person, in advance of providing any uncovered services or any services for which the patient is not eligible, that the medical service is not covered and that the Covered Persons will be responsible for all charges.
Sample 1
Copayments and Deductibles. Provider is entitled to xxxx and has the responsibility to collect from a Member any applicable copayments or deductibles for Covered Services according to the terms of this Agreement. Provider understands and agrees that because of the variety of benefit structures offered by Plan Benefit Programs, it is not always possible to determine, in advance, the deductible or copayment amounts to be paid by Members. Furthermore, Provider understands and agrees that PMC and Payers have no responsibility to pay any amount except as described in Section 6.1 and Provider shall xxxx and collect copayments, deductibles and any other fees that are the Member’s responsibility. For health care services not covered by this Agreement or which PMC and/or Payer determine are not Medically Necessary, and for so long as not prohibited by PMC and/or Payer, Provider may xxxx Member or other responsible party. Provider shall provide notice to PMC of all such charges. Provider agrees to notify Members, in advance of providing any uncovered services that the service is not covered by the Plan Benefit Program and that Member will be responsible for all charges.
Sample 1
Copayments and Deductibles. Pharmacy agrees to collect from each Covered Person or Representing Agent the applicable Copayment, Coinsurance, and Deductible, when applicable, on each prescription order. It is the Pharmacy’s obligation to determine the applicable Copayment, Coinsurance or Deductible amounts through the use of the System. Unless required by law, Pharmacy agrees that it shall not waive the Copayment, Coinsurance or Deductible on the part of a Covered Person without express written consent of ProCare, and that Copayment, Coinsurance or Deductible returned from the System is the maximum allowable amount which shall be collected by Pharmacy from the Covered Person or Representing Agent. Pharmacy may not charge any amount greater than the Covered Person’s amount due sent back to the Pharmacy via the System. Pharmacy may apply standard senior citizen or other discounts when Covered Persons are required to pay the full Usual and Customary (“U&C”) charges for Services.
Sample 1
Copayments and Deductibles. From and after the Effective Time, Buyer will, or will cause the Surviving Company and its subsidiaries to, waive any pre-existing condition exclusions and actively-at-work requirements under any employee benefit plan or program in which a Covered Employee becomes eligible to participate following the Closing (the “Surviving Company Benefit Plans”) (except to the extent that such exclusions and requirements were not waived by the Company or the Subsidiaries), and will make commercially reasonable efforts to provide that any covered expenses incurred on or before the Effective Time by an employee or an employee’s covered dependents under the Company’s employee benefit plans will be taken into account under the applicable Surviving Company Benefit Plans for purposes of satisfying applicable deductible, coinsurance and maximum out-of-pocket provisions after the Effective Time.
Sample 1
Copayments and Deductibles. All copayments and deductibles are to be paid at the time of service. This arrangement is part of your contract with your insurance company. If you have a high deductible insurance plan, you will be required to pay $50 toward your deductible at the time of service and we will bill you for any remaining balance after your insurance has processed the bill.
Sample 1
Copayments and Deductibles. Participating Provider shall xxxx and has the responsibility to collect from a Participating Patient any applicable copayments or deductibles for Covered Medical Services according to the terms of the applicable group health insurance benefit plan between Group and the Participating Patient. The WPPA shall notify Provider of the applicable copayments and deductibles for each Group's benefit plan. For medical services provided but not covered by the Group's health insurance benefit plan, the Provider may xxxx and collect the Provider's usual, customary, and reasonable charges from Participating Patient or other responsible party.
Sample 1
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Copayments and Deductibles. Ancillary Provider understands and agrees that the Payor (or, if applicable, CCPN) has no responsibility to pay any amount except as described in Paragraph 4.2 above and Ancillary Provider shall, unless prohibited by state or federal law, bill xxx attempt to collect copayments, deductibles and any other fees which are the Covered Person's responsibility under the Covered Person's Payor Plan. For medical services not covered by this Agreement and for so long as not prohibited by CCPN and/or Payor or by state or federal law, Ancillary Provider may bill x Xovered Person or other responsible party.
Sample 1
Copayments and Deductibles. The Participating Hospital shall xxxx and has the responsibility to collect from a Participating Patient any applicable copayments or deductibles for Covered Hospital Services according to the terms of the applicable group health benefit plan between Group and the Participating Patient. For hospital services provided but not covered by the Group's health benefit plan, the Hospital may xxxx and collect the Hospital's usual, customary, and reasonable charges from Participating Patient or other responsible party.
Sample 1

Related to Copayments and Deductibles

  • Copayments Effective January 1, 2019, the State Dental Plan will cover allowable charges for the following services subject to the copayments and coverage limits stated. Higher out-of-pocket costs apply to services obtained from dental care providers not in the State Dental Plan network. Services provided through the State Dental Plan are subject to the State Dental Plan's managed care procedures and principles, including standards of dental necessity and appropriate practice. The plan shall cover general cleaning two (2) times per plan year and special cleanings (root or deep cleaning) as prescribed by the dentist. Service In-Network Out-of-Network Diagnostic/Preventive 100% 50% after deductible Fillings 80% after deductible 50% after deductible Endodontics 80% after deductible 50% after deductible Periodontics 80% after deductible 50% after deductible Oral Surgery 80% after deductible 50% after deductible Crowns 80% after deductible 50% after deductible Implants Prosthetics 80% after deductible 80% after deductible 50% after deductible 50% after deductible Prosthetic Repairs 80% after deductible 50% after deductible Orthodontics 80% after deductible 50% after deductible

  • Deductibles The Department shall be exempt from, and in no way liable for, any sums of money representing a deductible in any insurance policy. The payment of such deductible shall be the sole responsibility of the Grantee providing such insurance.

  • Deductibles and Self-Insurance Retentions Any deductibles or self-insured retentions must be declared to and approved by the City. The City may require the Consultant to provide proof of ability to pay losses and related investigation, claims administration and defense expenses within the deductible or self-insured retention. The deductible or self-insured retention may be satisfied by either the named insured or the City.

  • Copayment A fixed amount You pay directly to a Provider for a Covered Service when You receive the service. The amount can vary by the type of Covered Service. Cost-Sharing: Amounts You must pay for Covered Services, expressed as Copayments, Deductibles and/or Coinsurance. Cover, Covered or Covered Services: The Medically Necessary services paid for, arranged, or authorized for You by Us under the terms and conditions of this Contract. Deductible: The amount You owe before We begin to pay for Covered Services. The Deductible applies before any Copayments or Coinsurance are applied. The Deductible may not apply to all Covered Services. You may also have a Deductible that applies to a specific Covered Service that You owe before We begin to pay for a particular Covered Service. Dependents: The Subscriber’s Spouse and Children. Emergency Dental Care: Emergency dental treatment required to alleviate pain and suffering caused by dental disease or trauma. Refer to the Pediatric Dental Care and Adult Dental Care sections of this Contract for details.

  • Deductibles and Self-Insured Retentions Any deductibles or self-insured retentions must be declared to, and approved by CITY's Risk Manager. At the option of CITY, either; the insurer shall reduce or eliminate such deductibles or self-insured retentions as respects CITY, its officer, employees, agents and contractors; or GRANTEE shall procure a bond guaranteeing payment of losses and related investigations, claim administration and defense expenses in an amount specified by the CITY's Risk Manager.

  • Deductibles and Self-Insured Retention Any deductible or self-insured retention that apply to any insurance required by this Agreement must be declared and approved by COUNTY.

  • Health and Hospitalization Insurance Single Coverage: The District shall contribute a sum not to exceed $8180 per year toward the premium for individual coverage for each full-time employee employed by the District who qualifies for and is enrolled in single cov- erage in the School District’s group health and hospitalization insurance plan. Any additional cost of the premium shall be borne by the employee and paid by payroll deduction.

  • Hospitalization Insurance The Employer shall provide: HOSPITALIZATION INSURANCE Effective as soon as is practical after September 1, 2011 or date of ratification, whichever is sooner. Community Blue PPO 4$2/25/50 Prescription Drug Rider Dental Plan 2 $ Mandatory Mail-Order for Maintenance Drugs $ On Mail-Order- Pay for 2 month supply, get 3 month supply $ Mandatory Generic Drugs$ $10 Office and Chiropractic Visit Employees Contribute $10 per Pay Period for spousal coverage. Effective the first pay period after 9/1/2011 or as soon as is practicable employees hired before 9/1/11 shall pay 5% of the illustrated rate for the health and dental coverage they select. Effective 1/1/2012 employees hired before 9/1/11 shall pay 10% of the illustrated rate for the health and dental coverage they select. Effective the first pay period after 9/1/2011 or as soon as is practicable, for employees hired on or after 9/1/11, employees shall contribute 20% of the illustrated rate for the coverage the employee selects.

  • Workers’ Compensation Insurance Contractor shall obtain and maintain a policy of workers’ compensation insurance for all of Contractor’s employees in accordance with the provisions of Labor Code Sections 3700, et seq., and all other applicable laws and requirements. In case any class of employee is not protected under the workers’ compensation laws for any reason, Contractor shall provide adequate coverage as shall be necessary for the protection of such employees. Prior to commencement of the Work, Contractor shall sign and file with District a certification regarding insurance for workers’ compensation in accordance with Labor Code Section 1861.

  • Insurance, Loss Deductible The Customer shall be exempt from, and in no way liable for, any sums of money which may represent a deductible in any insurance policy. The payment of such deductible shall be the sole responsibility of the Contractor providing such insurance. Upon request, the Contractor shall furnish the Customer an insurance certificate proving appropriate coverage is in full force and effect.

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