Private Insurance Clause Samples
The Private Insurance clause establishes the requirement or option for a party to obtain and maintain insurance coverage from private insurers. Typically, this clause outlines the types and minimum amounts of insurance needed, such as liability or property insurance, and may specify acceptable insurers or proof of coverage. Its core practical function is to ensure that adequate financial protection is in place to cover potential losses or liabilities, thereby reducing risk and providing assurance to the parties involved.
Private Insurance. If Grantee is a private entity, or if any contractors, subcontractors, or subgrantees used to carry out the Project are private entities, Grantee and any private contractors, subcontractors or subgrantees must obtain and maintain insurance covering Agency in the types and amounts indicated in Exhibit C.
Private Insurance. If you have insurance or health care coverage, our billing service will bill your insurance company or health carrier for you. By entering into this contract, you authorize us to release health information to our billing service, and for our billing service to release health information to your insurance company or health carrier for the purpose of processing your claims. Our billing service may bill your insurance company or health carrier for the following services related to your care including, but not limited to: If your insurance denies your claims, you are responsible for paying us the entire fee. If, upon verification of benefits, your insurance company is likely to pay, we may agree to only collect the deposit, your deductibles for you and your baby, and approximate coinsurance amounts (patient responsibility or “PR”) up front, rather than collecting the entire fee. If your insurance company pays, and we find that we have overcharged you, we will refund you accordingly. If the insurance assigns PR that exceeds what we have collected from you, we will bill you for the deficit. If you have insurance and you’ve paid the entire fee in advance, and if your insurance company pays us directly, we will send you a refund. Your refund cannot exceed the amount you prepaid less your non-refundable deposit. Your refund amount will be affected by your assigned PR amounts and any deductibles (for you and your baby) applied to our claims independently of reimbursement amounts we receive. If your insurance company reimburses you directly, you agree to cooperate with our billing service. Our billing service will determine how much of the reimbursement should be sent to us, and how much, if any, is yours to keep. In this situation, you agree to reimburse us immediately. Any unpaid balance remaining 30 days after the insurance reimbursement was sent is considered delinquent and is subject to a 1.5% monthly interest charge. Client agrees to pay a non-refundable deposit of $200.00 which covers adminstrative and insurance billing services. Vivante pays an average of $200-$250 to the billing service for each claim processed. The birth assistant fee of $400, is payable by check at 36 weeks, and is not billable to insurance. The birth assistant fee is paid directly to a third-party subcontractor. Client agrees to pay all third-party vendors and subcontractors for birth assistant fee.
Private Insurance. If Grantee is a private entity, or if any contractors, subcontractors, or
Private Insurance. Variables identifying private insurance in general (PRIV1, PRIV2, PRIV3, PRIV96, PRIVAT1, PRIVAT2, PRIVAT96) and specific private insurance sources [such as employer/union group insurance (PRIEU1, PRIEU2, PRIEU3, PRIEU96); non-group (PRING1, PRING2, PRING3, PRING96); and other group (PRIOG1, PRIOG2, PRIOG3, PRIOG96)] were constructed. Variables indicating any private insurance coverage are available for the following time periods: at any time in Rounds 1, 2 or the 1996 portion of Round 3, at the interview dates and on December 31st. The variables for the specific sources of private coverage are only available for coverage on the interview dates and on December 31st. Note that these variables indicate coverage within a source and do not distinguish between persons who are covered on one or more than one policy within a given source. In some cases, the policyholder was unable to characterize the source of insurance (PRIDK1, PRIDK2, PRIDK3, PRIDK96). Covered persons are also identified when the policyholder is living outside the RU (PROUT1, PROUT2, PROUT3, PROUT96). An individual was considered to have private health insurance coverage if, at a minimum, that coverage provided benefits for hospital and physician services (including Medigap coverage). Sources of insurance with missing information regarding the type of coverage were assumed to contain hospital/physician coverage. Persons without private hospital/physician insurance were not counted as privately insured. Health insurance through a job or union (PRIEU1, PRIEU2, PRIEU3, PRIEU96) was initially asked about in the Employment Section of the interview and later confirmed in the Health Insurance Section. Respondents also had an opportunity to report employer and union group insurance for the first time in the Health Insurance Section, but this insurance was not linked to a specific job. All insurance reported to be through a job classified as self-employed with firm size of 1 (PRIS1, PRIS2, PRIS3, PRIS96) was initially reported in the Employment Section and verified in the Health Insurance Section. Unlike the other employment-related variables, self-employed-firm size 1 health insurance could not be reported in the Health Insurance section for the first time. The variables PRIS1, PRIS2, PRIS3, PRIS96 have been constructed to allow users to determine if the insurance should be considered employment-related. Private insurance that was not employment-related was reported in the Health Insurance section only...
Private Insurance. Even when there is private insurance coverage, the Resident remains primarily responsible for paying all of the Home’s charges. Where the Resident’s private insurer is a managed care plan with which the Home has a contract, the Home agrees to invoice the managed care plan directly for the Resident’s care and services. However, all charges that are not covered by the managed care plan are the responsibility of the Resident. These non-covered charges include, but are not limited to, any coinsurance and/or deductible amounts which the managed care plan requires the Resident to pay, to the extent allowed under federal and state laws. Where the Resident’s private insurer is not a managed care plan with which the Home has a contract, the Home will invoice the Resident, who is primarily responsible for payment of the invoice. The Resident is responsible to notify the Home of any changes in insurance coverage. The Resident will be responsible for any charges that result when proper notice of non- coverage is not given or if the Resident fails to maintain private insurance coverage.
Private Insurance. The owner’s Public Liability Insurance only gives very limited protection.
Private Insurance. Drug and Alcohol Services does not accept or bill private insurance. We can provide referrals to other community providers or you may choose to self-pay for services (see below) on a sliding fee scale.
Private Insurance. The District will not assume any portion of personal property losses 10 under Sections 15 or 16 covered by private insurance carriers.
Private Insurance. When the resident has private insurance that is accepted by the facility, the facility will ▇▇▇▇ timely the private insurance company for the services provided to the resident. By submitting the claim to the private insurer, the facility is not making any representation or warranty about the availability or extent of coverage. If coverage is denied, the resident is obligated to pay for the services provided upon receipt of the coverage denial. Further, any appeal of a private insurance coverage decision is solely the responsibility of the resident and a pending appeal will not impact the resident’s obligation to pay for the services for which coverage was denied. If the private insurance company ultimately makes payment, the facility will promptly reimburse the resident. Finally, the resident agrees to promptly pay to the facility any deductible, co-payment or co- insurance amounts due as determined by the private insurance company.
Private Insurance. ~ Full payment is expected when services are rendered. Since you have a private contract with your insurance carrier, it will be your responsibility to follow up with your insurance carrier regarding denials and underpayment. If we should accept assignment of your insurance benefits due to an emergency situation, payment in full is expected within 30 days from date of service. HMO / PPO / Contracted Insurances ~ We will honor the terms of our contract with your insurance carrier providing one is in effect. You will be expected to pay all copays and non-covered charges at the time of service. We do not have a contract in effect with PPC Care Manager. It is your primary care physician’s responsibility to obtain an authorization number for you prior to the time of service. If you have not received an authorization number form your primary care provider full payment will be required at the time of service.