Non-Covered Services means those vision care services which are not Covered Services under Plan Contract(s).
Non-Covered Services means services or items for which the Authority is not responsible for payment or reimbursement. Non-covered services are identified in:
Non-Covered Services shall have the meaning given to such term in each applicable O&M Agreement.
Examples of Non-Covered Services in a sentence
To the extent permitted by law, Facility may bill Members directly for Non-Covered Services.
More Definitions of Non-Covered Services
Non-Covered Services means health care services that are not benefits under the Evidence of Coverage.
Non-Covered Services means those items and services that are not covered benefits under a particular CalOptima Program in accordance with the Evidence of Coverage or Member handbook and applicable State and Federal laws and regulations.
Non-Covered Services means those services not covered by a patient’s Health Insurance Policy. This definition includes services not covered (i) as a result of a pre-existing condition exclusion; (ii) because a patient has exhausted his or her benefits; (iii) because they are denied through a Health Insurance Policy’s pre- authorization process; and (iv) services for which the patient has elected to opt out of his or her Health Insurance Policy coverage and to pay out of pocket. For purposes of a Federal health care program beneficiary, “Non-Covered Services” means only those services that are statutorily excluded from coverage. Patient co- pays and deductibles are not considered “Non-Covered Services.”
Non-Covered Services means those services not covered by the Programs, such as procedures which are primarily for cosmetic purposes, for which dental necessity cannot be demonstrated, or which are otherwise determined to be beyond the scope of the Programs. Medical/dental supplies and equipment and other devices that are essential for the Member's medical/dental condition shall be allowable unless such services are otherwise available at no charge from community services (such as the American Cancer Society or other
Non-Covered Services means those vision care services which are not Covered Services and which are not covered benefits under the Plan Contracts between DAVIS and the Plan(s).
Non-Covered Services means those health care services and supplies that are not Covered Services under the applicable Payor Agreement and Plan.
Non-Covered Services are those services a) excluded from coverage by the HealthChoice Plan, in which case the Member is liable for the charges; or b) covered by the HealthChoice Plan but inappropriately billed or not considered to be Medically Necessary and therefore excluded for reimbursement based on the clinical editing, in which case the Member is not liable for the charges.