HC Program definition
Examples of HC Program in a sentence
Exception: An individual who is determined eligible for Healthy Horizons for cost sharing coverage only (categories PG and PL) will not be enrolled in the HC Program.
Nothing in this Agreement shall be deemed to create any association, partnership, joint venture, employment relationship, or agency relationship between the Client and the HC with respect to the HC Program or otherwise.
Change in Member’s status to a recipient group which is exempt from the HC Program.
Oxford shall further indemnify, defend and hold PA HRM harmless from and against any liability or claim arising from the operation of the HC Program prior to the Effective Date.
This Section 4.3 shall not prohibit collection of Covered Member deductibles or copayments (if permitted under the HC Program) or coordination of benefits, subrogation payments for services other than Covered Services, or other payments by other insurers or plans.
As a condition precedent to the adoption of the Transition Plan, Oxford shall provide to PA HRM all material information it has in its possession about the HC Program, including data tapes of the Oxford claims systems and other systems in a mutually acceptable format.
PA HRM shall assume full responsibility for the member services that are required under the HC Program and Oxford standards and policies.
During the Term, Oxford, as an HMO, shall be responsible for and perform the following services relating to the HC Program.
PA HRM shall assure that provider relations are managed to assure competent operation of the HC Program.
The foregoing shall not preclude the collection by Oxford Par Providers of deductibles and copayments or payments for services other than Covered Services from Covered Members as permitted under the applicable Oxford Plan and applicable HC Program provisions.