Covered Services which are Clause Samples
The 'Covered Services' clause defines the specific services that are included under the terms of an agreement. It typically outlines which tasks, deliverables, or activities the service provider is responsible for performing, and may reference schedules or exhibits that list these services in detail. By clearly identifying what is and is not covered, this clause helps prevent misunderstandings and disputes about the scope of work, ensuring both parties have a shared understanding of their obligations.
Covered Services which are. Not the Contractor’s Responsibility
(A) The Contractor shall not be required to provide, arrange for, or pay for Covered Services to Enrollees whose illness or injury results directly from a catastrophic occurrence or disaster, including, but not limited to earthquakes or acts of war. The effective date of excluding such Covered Services shall be the date specified by the Federal Government or the State of Utah that a Federal or State emergency exists or disaster has occurred.
(B) An Enrollee who is Indian may choose to seek Covered Services from an Indian Health Care Provider. The Contractor shall not be required to pay for Covered Services provided to Indian Enrollees who receive services provided by Indian Health Care Providers. Such services shall be paid by the Department.
Covered Services which are. Not the Contractor’s Responsibility
Covered Services which are. Not the Contractor’s Responsibility
(A) The Contractor shall not be required to provide, arrange for, or pay for Covered Services to Enrollees whose illness or injury results directly from a catastrophic occurrence or disaster, including, but not limited to earthquakes or acts of war. The effective date of excluding such Covered Services shall be the date specified by the Federal Government or the State of Utah that a Federal or State emergency exists or disaster has occurred.
Covered Services which are. Not Considered Medically Necessary by the PPO are not covered, unless, and only if, such services are specifically mandated by applicable state or federal law, or specifically covered as Preventive Services.