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 the Enrolled Member liability on claims for covered healthcare services will be based on the lower of the participating provider's billed covered charges or the negotiated price made available to BCBSRI by the Host Blue. Host Blues determine a negotiated price, which is reflected in the terms of each Host Blue’s healthcare provider contracts. The negotiated price made available to BCBSRI 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 the Enrolled Member liability on claims for covered healthcare services processed through the BlueCard Program, if not a flat dollar copayment, will be based on the lower of the participating healthcare provider's billed covered charges or the negotiated price made available to BCBSRI 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 healthcare provider contracts. The negotiated price made available to BCBSRI 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 the Enrolled Member Insured's liability on claims for covered healthcare services will be based on the lower of the participating provider's billed covered charges or the negotiated price made available to BCBSRI us by the Host Blue. Host Blues determine a negotiated price, which is reflected in the terms of each Host Blue’s 's healthcare provider contracts. The negotiated price made available to BCBSRI 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 calculation of the Enrolled Member liability on claims for covered healthcare services Covered Services will be based on the lower of the participating provider's ’s billed covered charges for Covered Services or the negotiated price made available to BCBSRI the Plan by the Host Blue. Host Blues determine a negotiated price, which is reflected in the terms of each Host Blue’s healthcare health care provider contracts. The negotiated price made available to BCBSRI the Plan 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 Enrolled Member member liability on claims for covered healthcare services will be based on the lower of the participating provider's billed covered charges or the negotiated price made available to BCBSRI Blue Cross and Blue Shield of Alabama by the Host Blue. Host Blues determine a negotiated price, which is reflected in the terms of each Host Blue’s healthcare provider contracts. The negotiated price made available to BCBSRI Blue Cross and Blue Shield of Alabama 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 Enrolled Member Covered Person’s liability on claims Claims for covered healthcare services Covered Services will be based on the lower of the participating healthcare provider's billed covered charges or the negotiated price made available to BCBSRI BCBSNE by the Host Blue. Host Blues determine a negotiated price, which is reflected in the terms of each Host Blue’s healthcare provider contracts. The negotiated price made available to BCBSRI BCBSNE by the Host Blue may be represented by one of the following: