Common use of Second Opinion Clause in Contracts

Second Opinion. A member is entitled to a second opinion from a qualified health professional within the network or, if a network provider is not available to provide a second opinion, the Contractor must arrange for a second opinion by a non-participating provider outside of the network. Except for allowed cost-sharing, the member is not responsible for the cost of obtaining a second opinion.

Appears in 37 contracts

Sources: Contract for Medicaid Managed Care Services, Medicaid Managed Care Services Agreement, Contract for Medicaid Managed Care Services

Second Opinion. A member is entitled to a second opinion from a qualified health professional within the network or, if a network provider is not available approved by the Contractor, to provide a second opinion, the Contractor must arrange for a second opinion by a non-participating provider outside of the network. Except for allowed cost-sharing, at no cost to the member is not responsible for the cost of obtaining a second opinionmember.

Appears in 11 contracts

Sources: Medicaid Program Agreement, Medicaid Rite Smiles Program Agreement, Medicaid Rite Smiles Program Agreement

Second Opinion. A member is entitled to a second opinion from a qualified health professional within the network or, if a network provider is not available to provide a second opinion, or request that the Contractor must arrange for a second opinion by a non-participating provider outside of the network. Except for allowed cost-sharing, at no cost to the member is not responsible for the cost of obtaining a second opinionmember.

Appears in 2 contracts

Sources: Contract for Medicaid Managed Care Services, Contract for Medicaid Managed Care Services