COVERED BY INSURANCE. Article 13. The insured event is an event where a medically justified treatment (health services, medicines, medical-technical aids, implants, etc.) is carried out for the insured person due to health disorders (illness or injury) and which is the subject of the insurance contract and the expenses of which have to be paid to the health insurance institutions, private practice, other health care provider or insured person. If an insured event occurs within the scope of these Terms, the insurer is required to reimburse the insured for the standard and usual expenses up to the agreed amount of coverage, which arise during the term of the insurance contract, in connection with a medically justified treatment performed for the insured. Notwithstanding paragraph 2 of this Article, if the insured event occurred prior to the beginning of the insurance coverage, and the treatment for that insured event also takes place after the beginning of the insurance coverage, the Insurer is not required to bear the costs incurred for such treatment. In any case, the insured event ends with expiry of the insurance contract, in accordance with the General Conditions.
COVERED BY INSURANCE. You are responsible for knowing the terms and the exclusions of your policy. • To maximize your benefits, it is essential that you provide our office with accurate and complete billing information before services are rendered. If this is not achieved, we will treat it as though no coverage exists and our policies for non-insured patients will apply. • We are happy to send a pre-authorization to your insurance company to determine estimated benefits and strongly suggest doing so. This is not, however, a guarantee of what your insurance company will cover and it can take up to several weeks to receive this information from your insurance company. Not all circumstances allow the time necessary to accomplish this. • Often, people are under the impression that if a person has insurance, it is the insurance company who owes the doctor for services rendered. The insurance contract, however, is between the patient and the insurance company only. Therefore, the patient (of the guarantor) is ultimately responsible for the bill, regardless of insurance coverage determination (or pre- determination). All treatment fees are due within 60 days, regardless of insurance payment.
COVERED BY INSURANCE. Costs incurred by Contractor which Contractor can recover from any insurers or from another party.
COVERED BY INSURANCE
