Common use of Exception for Other Coverage Clause in Contracts

Exception for Other Coverage. A Participating Provider may seek reimbursement from other third-party payors for the balance of their charges for services you receive under this plan. If you recover from a third party the reasonable value of Covered Services received from a Participating Provider, the Participating Provider is not required to accept the fees paid by Blue Shield as payment in full. You may be liable to the Participating Provider for the difference, if any, between the fees paid by Blue Shield and the reasonable value recovered for those services.