Recognized Charges definition
Examples of Recognized Charges in a sentence
Recognized Charges paid by Payor will or may be reduced by any applicable Copayment, Deductible, or Coinsurance payable by the Member.
As set forth in Section 3.1 herein, Crescent adheres to the “Messenger Model” and will not negotiate, agree upon or otherwise seek to determine Recognized Charges or other competitively sensitive terms for Provider.
Upon receipt of the schedule of Recognized Charges, if applicable, and a description of obligations imposed by the contract terms in connection with an existing or proposed Crescent Network Access Agreement, Provider may decline to or agree to or may choose to become, under the terms of Section 3.1 herein, an In-Plan Provider for, and to render Provider Services to Members of such Plans as defined in the applicable Crescent Network Access Agreement.
If no schedule of Recognized Charges for Facility Services is proposed by the Payor or TPA, the Facility agrees to comply with procedures described in Section 3.1 herein by negotiating in good faith with the Payor or TPA.
If, after reviewing the fee information provided pursuant to this Section 3.1(b), a Plan offers compensation terms applicable to Provider (such as a schedule of Recognized Charges for Provider Services), all of the protocols, procedures, deadlines and notice provisions set forth in Section 3.1(a) above shall apply to such offer.
If Facility so authorizes Crescent, and a Plan’s Recognized Charges are equal to or better than Facility’s individually-determined minimum fees, Facility will become an In-Plan Provider for such Payor(s) Plan(s) through Crescent and will accept as compensation the Plan’s Recognized Charges.
Provider may also, at its option, elect to authorize Crescent to contract on Provider’s behalf with Plans offering Recognized Charges equal to or better than Provider’s individually-determined minimum fees.
If Provider so authorizes Crescent, and a Plan’s Recognized Charges are equal to or better than Provider’s individually-determined minimum fees, Provider will become an In-Plan Provider for such Payor(s) Plan(s) through Crescent and will accept as compensation the Plan’s Recognized Charges.
Provider agrees that Coinsurance payments due and collected from Members will be computed based on the Recognized Charges rather than on Provider’s usual or customary fees or rates.
Crescent shall not be liable to Facility or any other person for a failure of the Payor to pay any Recognized Charges or for any other breach of Payor's obligations to Crescent, Facility or any other person.