Medicare Members Clause Samples
The "Medicare Members" clause defines the specific terms and conditions that apply to individuals enrolled in Medicare within the context of the agreement. It typically outlines eligibility requirements, coverage limitations, and any special procedures or obligations for Medicare beneficiaries, such as billing practices or coordination of benefits. This clause ensures that the contract complies with federal regulations governing Medicare and clarifies the rights and responsibilities of both parties when dealing with Medicare-covered individuals, thereby reducing the risk of non-compliance and misunderstandings.
Medicare Members. If a Medicare Appendix is attached to this Agreement, Provider agrees to provide MHSA Services under this Agreement, to Members who are enrolled in a Benefit Plan for Medicare beneficiaries and to cooperate and comply with the provisions set forth in the attached Medicare Advantage Addendum. Provider also understands that UBH's agreements with Participating Providers are subject to review and approval by the Centers for Medicare and Medicaid Services (“CMS”).
Medicare Members. Medicare members acknowledge and understand that SMG, PA and physician(s) are non- participating in Medicare, and have opted out of Medicare. This means that Medicare cannot be billed for any services performed for the member by SMG, PA or physician(s). The member agrees not to make an attempt to collect from Medicare the membership fee for any services provided under the agreement. (Excluding labs and diagnosis tests etc). If a member becomes eligible for Medicare while under the care of SMG, PA, he/she has a choice to find a physician who accepts Medicare, or to remain with SMG, PA. For ancillary services the Medicare patient can be referred to an outside lab/facility that accepts Medicare.
Medicare Members. Medicare members acknowledge and understand that Direct Primary Care Associates, PLLC and physician(s) are non- participating in Medicare, and have opted out of Medicare. This means that Medicare cannot be billed for any services performed for the member by Direct Primary Care Associates, PLLC or physician(s). The member agrees not to make an attempt to collect from Medicare the membership fee for any services provided under the agreement. (Excluding labs and diagnosis tests etc). If a member becomes eligible for Medicare while under the care of Direct Primary Care Associates, PLLC, he/she has a choice to find a physician who accepts Medicare, or to remain with Direct Primary Care Associates, PLLC. For ancillary services the Medicare patient can be referred to an outside lab/facility that accepts Medicare.
Medicare Members. If a Medicare Appendix is attached to this Agreement, Provider agrees to provide Covered Services to Members enrolled in a Benefit Contract for Medicare beneficiaries and to comply with any additional requirements set forth in the Medicare Appendix. Provider also understands that Optum’s agreements with Providers are subject to review and approval by the Centers for Medicare and Medicaid Services (“CMS”).
Medicare Members. Humana agrees to pay Provider for Covered Services provided to Members who have been assigned to Provider, according to the payment arrangement set forth below:
Medicare Members. Medicare members acknowledge and understand that Functional Family and providers are nonparticipating in Medicare, and have opted out of Medicare. This means that Medicare cannot be billed for any services performed for the member by Functional Family or provider(s). The member agrees not to make an attempt to collect from Medicare the membership fee for any services provided under the agreement. (Excluding labs and diagnosis tests etc). If a member becomes eligible for Medicare while under the care of Functional Family, he/she has a choice to find a provider who accepts Medicare, or to remain with Functional Family. For ancillary services, the Medicare patient can be referred to an outside lab/facility that accepts Medicare.