Common use of Providing Covered Services Clause in Contracts

Providing Covered Services. Provider shall follow the authorization and referral procedures set forth in the Provider Manual for the authorization and payment of Covered Services. Provider shall provide authorized Covered Services to Members consistent with the scope of his/her license to practice. Provider shall consult with and seek further authorization from Health Plan or Member’s Primary Care Practitioner if he/she believes that additional treatment or tests are needed beyond those initially authorized. Provider understands and agrees that Health Plan’s authorization of services does not constitute a guarantee of Health Plan payment for such services.

Providing Covered Services. Provider shall follow the authorization and referral procedures set forth in the Provider Manual for the authorization and payment of Covered Services. Provider shall provide authorized Covered Services to Members consistent with the scope of his/her license to practice. Provider shall consult with and seek further authorization from Health Plan or Member’s Primary Care Practitioner Provider if he/she believes that additional treatment or tests are needed beyond those initially authorized. Provider understands and agrees that Health Plan’s authorization of services does not constitute a guarantee of Health Plan Plan’s payment for such services.