Common use of Liability Calculation Method Per Claim Clause in Contracts

Liability Calculation Method Per Claim. Unless subject to a fixed dollar copayment, the calculation of Member liability on claims for Out-of-Area Covered Health Care Services processed through the BlueCard Program will be based on the lower of the provider’s billed charges or the negotiated price made available to Blue Shield by the Host Blue. Host Blues determine a negotiated price, which is reflected in the terms of each Host Blue’s health care provider contracts. The negotiated price made available to Blue Shield by the Host Blue may be represented by one of the following:

Liability Calculation Method Per Claim. Unless subject to a fixed dollar copaymentCopayment, the calculation of the Member liability on claims for Out-of-Area Covered Health Care Healthcare Services processed through the BlueCard Program will be based on the lower of the provider’s providers billed charges for Out-of-Area Covered Healthcare Services or the negotiated price made available to Blue Shield us by the Host Blue. Host Blues determine a negotiated price, which is reflected in the terms of each Host Blue’s health care healthcare provider contracts. The negotiated price made available to Blue Shield BCN by the Host Blue may be represented by one of the following:

Liability Calculation Method Per Claim. Unless subject to a fixed dollar copayment, the The calculation of Member the Member's liability on claims for Out-of-Area Covered Health Care Services covered healthcare services processed through the BlueCard Program will be based on the lower of the participating healthcare provider’s 's billed covered charges or the negotiated price made available to Blue Shield BCN by the Host Blue. Host Blues may use various methods to determine a negotiated price, which is reflected in depending on the terms of each Host Blue’s health care 's healthcare provider contracts. The negotiated price made available to Blue Shield BCN by the Host Blue may be represented represent a payment negotiated by a Host Blue with a healthcare provider that is one of the following:

Liability Calculation Method Per Claim. Unless subject to a fixed dollar copayment, the The calculation of Member the Member's liability on claims for Out-of-Area Covered Health Care Services covered healthcare services processed through the BlueCard Program will be based on the lower of the participating healthcare provider’s 's billed covered charges or the negotiated price made available to Blue Shield BCBSM by the Host Blue. Host Blues may use various methods to determine a negotiated price, which is reflected in depending on the terms of each Host Blue’s health care 's healthcare provider contracts. The negotiated price made available to Blue Shield BCBSM by the Host Blue may be represented represent a payment negotiated by a Host Blue with a healthcare provider that is one of the following:

Liability Calculation Method Per Claim. Unless subject to a fixed dollar copayment, the The calculation of Member the member liability on claims for Out-of-Area Covered Health Care Services covered health care services processed through the BlueCard Program Program, if not a flat dollar copayment, will be based on the lower of the health care provider’s 's billed covered charges or the negotiated price made available to Blue Shield by the Host Blue. Host Blues may use various methods to determine a negotiated price, which is reflected in depending on the terms of each Host Blue’s health care provider contracts. The negotiated price made available to Blue Shield by the Host Blue may be represented represent a payment negotiated by a Host Blue with a health care provider that is one of the following:

Liability Calculation Method Per Claim. Unless subject to a fixed dollar copayment, the The calculation of the Member liability on claims for Out-of-Area Covered Health Care Services covered health care services processed through the BlueCard Program Program, if not a flat dollar copayment, will be based on the lower of the health care provider’s 's billed covered charges or the negotiated price made available to Blue Shield by the Host Blue. Host Blues may use various methods to determine a negotiated price, which is reflected in depending on the terms of each Host Blue’s health care provider contracts. The negotiated price made available to Blue Shield by the Host Blue may be represented represent a payment negotiated by a Host Blue with a health care provider that is one of the following:.

Liability Calculation Method Per Claim. Unless subject to a fixed dollar copayment, the The calculation of Member liability on claims the member copay, if not a flat dollar copay, for Outout-of-Area Covered Health Care Services area covered healthcare services processed through the BlueCard Program will be based on the lower of the participating healthcare provider’s 's billed covered charges or the negotiated price made available to Blue Shield Anthem by the Host Blue. Host Blues may use various methods to determine a negotiated price, which is reflected in depending on the terms of each Host Blue’s health care healthcare provider contracts. The negotiated price made available to Blue Shield Anthem by the Host Blue may be represented represent a payment negotiated by a Host Blue with a healthcare provider that is one of the following:

Liability Calculation Method Per Claim. Unless subject to a fixed dollar copaymentCopayment, the calculation of the Member liability on claims for Out-of-Area Covered Health Care Healthcare Services processed through the BlueCard Program will be based on the lower of the provider’s providers billed charges for Out-of-Area Covered Healthcare Services or the negotiated price made available to Blue Shield us by the Host Blue. Host Blues determine a negotiated price, which is reflected in the terms of each Host Blue’s health care healthcare provider contracts. The negotiated price made available to Blue Shield BCBSM by the Host Blue may be represented by one of the following:

Liability Calculation Method Per Claim. Unless subject to a fixed dollar copayment, the calculation of the Member liability on claims for Out-of-Area Covered Health Care Healthcare Services processed through the BlueCard Program will be based on the lower of the provider’s 's billed covered charges or the negotiated price made available to Blue Shield us by the Host Blue. Host Blues determine a negotiated price, which is reflected in the terms of each Host Blue’s health care healthcare provider contracts. The negotiated price made available to Blue Shield us by the Host Blue may be represented by one of the following:

Liability Calculation Method Per Claim. Unless subject to a fixed dollar copayment, the The calculation of Member liability on claims for Out-of-Area Covered Health Care Services covered health care services processed through the BlueCard Blue Card Program will be based on the lower of the provider’s participating Provider's billed covered charges or the negotiated price made available to Blue Shield BCBSNC by the Host Blue. The methods employed by a Host Blues Blue to determine a negotiated price, which is reflected in price may vary among Host Blues based on the terms of each Host Blue’s health care provider Provider contracts. The negotiated price made available to Blue Shield BCBSNC by the a Host Blue may be represented by represent a payment that is one of the following: