Common use of Member Billing Clause in Contracts

Member Billing. Provider shall not bill any Covered Person for Covered Services, except for specified coinsurance, copayments, and applicable deductibles. Nothing in this provision shall prohibit Provider from agreeing with a Covered Person to continue non-Covered Services at the Covered Person’s own expense, as long as Provider has notified the Covered Person in advance that Tailored Plan may not cover or continue to cover specific services. Provider shall have the responsibility to collect from the Covered Person applicable deductibles, copayments, coinsurance, and fees for non-Covered Services. (Section VII. Attachment G.1.1(h) p 80)