Payment for Multiple Procedures. Where multiple outpatient surgical or scope procedures performed on a Covered Person during a single occasion of surgery, reimbursement will be as follows: i) the procedure for which the Allowed Amount under this Compensation Schedule is greatest will be reimbursed at one hundred percent (100%) of such Allowed Amount; ii) the procedures with second greatest Allowed Amounts under this Compensation Schedule will be reimbursed at twenty five percent (25%) of such Allowed Amounts; and iii) any additional procedures will not be eligible for reimbursement.
Appears in 4 contracts
Samples: Participating Provider Agreement, Participating Provider Agreement, Participating Provider Agreement (Carolina Complete Health Network, Inc.)
Payment for Multiple Procedures. Where multiple outpatient surgical or scope procedures performed on a Covered Person during a single occasion of surgery, reimbursement will be as follows: i) the procedure for which the Allowed Amount under this Compensation Schedule is greatest will be reimbursed at one hundred percent (100%) of such Allowed Amount; ii) the procedures with second greatest Allowed Amounts under this Compensation Schedule will be reimbursed at twenty five percent (25%) of such Allowed Amounts; and iii) any additional procedures will not be eligible for reimbursement. 1 Particular contents of this Attachment will vary depending on the type of provider.
Appears in 2 contracts
Samples: Participating Provider Agreement, Participating Provider Agreement (Carolina Complete Health Network, Inc.)
Payment for Multiple Procedures. Where multiple outpatient surgical or scope procedures performed on a Covered Person during a single occasion of surgery, reimbursement will be as follows: i) the procedure for which the Allowed Amount under this Compensation Schedule is greatest will be reimbursed at one hundred percent (100%) of such Allowed Amount; ii) the procedures with second and third greatest Allowed Amounts under this Compensation Schedule will each be reimbursed at twenty five fifty percent (2550%) of such Allowed Amounts; and iii) any additional procedures will not be eligible for reimbursement.
Appears in 1 contract
Samples: Participating Provider Agreement