Network Authorization. For services that cannot be provided by a network provider, you can request a network authorization to seek services from a non-network provider. With an approved network authorization, the network benefit level will apply to the authorized covered healthcare service. If we approve a network authorization for you to receive services from a non- network provider, our reimbursement will be based on the lesser of our allowance, the non-network provider’s charge, or the benefit limit. For more information, please see the How Non-Network Providers Are Paid section. If you are in active treatment for pregnancy or a serious health condition with a network provider and there is a change to the network so that this provider is no longer in the network, please contact us for more information about whether that provider’s services to treat your pregnancy or serious health condition can continue to be covered at the network benefit level.
Appears in 12 contracts
Samples: Subscriber Agreement, Subscriber Agreement, Subscriber Agreement
