Non-Covered Services. MCOs are not permitted to provide Medicaid excluded services that include, but are not limited to, the following:
Non-Covered Services. The Contractor shall refer Members to Providers enrolled in the Medicaid Fee-for- Service delivery system for all Medically Necessary Services not covered by the Contractor under the MississippiCAN Program. The Contractor shall have written policies and procedures for the referral of Members for non-covered services, which shall provide for the smooth transition to Out-of-network Providers and assistance to Members in obtaining a new PCP, if appropriate. These procedures shall be applicable to the referral of Members to Out-of- network Providers, as necessary, upon Disenrollment, regardless of the reasons for Disenrollment.
Non-Covered Services. Patient understands and acknowledges that Patient is responsible for any charges incurred for health care services performed outside of the physical office space location as set forth above, including, but not limited to, emergency room visits, hospital and specialist care, and imaging and lab tests performed by third parties. Patient shall also be responsible for any charges incurred for health care services provided by the Practice not specifically described in Section 1 hereof. THE PRACTICE STRONGLY ENCOURAGES THE PATIENT TO MAINTAIN HEALTH INSURANCE DURING THE TERM OF THIS MEMBERSHIP AGREEMENT TO COVER SERVICES THAT ARE NOT PROVIDED UNDER THIS MEMBERSHIP AGREEMENT. PATIENT SHOULD PURCHASE HEALTH INSURANCE TO COVER, AT MINIMUM, UNPREDICTABLE AND CATASTROPHIC EXPENSES.
Non-Covered Services. Before a Provider provides items or services to a Member that are not Covered Services, Provider shall (a) inform the Member of the specific items or services that are not Covered Services and that they will not be paid for by Health Plan, and (b) obtain the Member’s written agreement to pay for such specific items or services after being so advised. Provider may contact Health Plan to determine if an item or service is a Covered Service.
Non-Covered Services. You agree not to xxxx, charge, or seek compensation, remuneration, or reimbursement from any State Health Plan Member, us, or any third party for health care services and/or supplies provided to State Health Plan Members which are determined by us not to be Covered Services, Medically Necessary, or are not payable due to your failure to follow our applicable Policies and Procedures, except as provided in Section 4.5.6.
Non-Covered Services. A. The Contractor is not responsible for the following:
Non-Covered Services. Nothing in this Agreement shall be construed to prohibit or otherwise restrict Practitioner from advising or advocating on behalf of Member about Member’s health status, medical care, or treatment options; the risks, benefits, and consequences of treatment or non-treatment; or the opportunity for Member to refuse treatment or to express preferences about future treatment decisions, regardless of Health Plan benefit coverage limitations. The parties recognize that Members may consent to receive services that are not Covered Services or are not authorized by Health Plan and therefore, may be payable by Member. Practitioner is responsible for confirming all proposed services as Covered Services and for verifying proper authorization of such services prior to treating Member. When proposed services are not payable by Health Plan, Practitioner must inform Member in advance and should document in writing Member’s consent to be billed for the services.
Non-Covered Services. To the extent required by the applicable Crescent Network Access Agreement, Facility may only charge, bill and collect from a Member charges for healthcare services which are not Covered Services if the Member has signed a waiver acknowledging that such services were not authorized for reimbursement by Xxxxx and that the Member will pay such charges. Facility shall have no obligation to provide services that are not Covered Services to Members, except as required by law. Facility shall have the right to pursue collections of debts incurred for services rendered to a Member prior to his or her enrollment with Payor. To the extent permitted by law, Facility may bill Members directly for Non-Covered Services.
Non-Covered Services. Services not covered under the applicable Benefit Plan are not subject to the rates or discounts of this Agreement. Participating Professional may seek and collect payment from a Customer for such services (provided that Participating Professional obtained the Customer’s prior written consent).
Non-Covered Services. No benefits are payable pursuant to this Agreement which are not otherwise payable by Member's MA PPO Benefit Contract.
