CHOICECARE NETWORK REIMBURSEMENT Sample Clauses

CHOICECARE NETWORK REIMBURSEMENT. Group agrees to accept as payment in full from Payors for Covered Services rendered to Members, the percentage defined below of ChoiceCare’s ( 079-787 ) fee schedule, or Group’s billed charges, whichever is less, less any Co-payments due from Members. All payments from ChoiceCare will be reduced by any deductibles or co-payments due from Member. Reimbursements broken down by code ranges and percentage payable for the above listed plans indicating (079-787) fee schedule: • Evaluation and Management Services (Codes 99201 to 99499): ALl covered services for evaluation and management services will be reimbursed zero with the exception of 99214, 99215, and 99212. CPT Code 99214 will be reimbursed at [****] of fixed 2006 Medicare RBRVS schedule. CPT Code 99215 will be reimbursed at [****]. CPT Code 99212 which will be [****]. • Surgery Services (Codes 10021 to 11471): CPT Code 10060, 10120, 11100, will be reimbursed at[****]. All other covered services for surgery services will be reimbursed at [****]. • Surgery Services (Codes 11600 to 11719 and 11770 to 69990): CPT code 11730, 11740, 11750, 12001, 12002, 12004, 12011, 12013, 12014, 12031, 12032, 12034, 12041, 12042, 12044, 12051, 12052, 12053, 16020, 16025, 16030, 17110, 29505, 20515, 29125, 29105, 29130, 30901, 65205, 65220, and 69210 will be reimbursed at [****]. All other covered services for radiology services will be reimbursed at [****]. • Radiology - Including Nuclear Medicine and Diagnostic Ultrasound Services (Codes 70010 to 79999): All covered services for radiology services will be reimbursed at [****]. [****] Certain information on this page has been omitted and filed separately with the Commission. Confidential treatment has been requested with respect to the omitted portions. • Pathology and Laboratory Services (Codes 80048 to 89399): ChoiceCare’s STAT pathology and laboratory codes are fixed at [***]. ChoiceCare’s STAT laboratory codes are as follows: 81000, 81002, 81005, 81015, 81025, 82270, 82947, 82948, 85007, 85008, 85009, 85013, 85014, 85021, 85022, 85027, 85031, 87205, 87207, 87210, 87220, and 87880. CPT Code 36415 when appropriate will be paid at [****]. CPT Codes 82962, 86677, 87804, and 86308, will be paid at [****]. All other covered services for pathology and laboratory will be reimbursed at [****]. • Medicine Services (except Anesthesiology and vaccines) (Codes 90281 to 90474 and 90760 to 92504 and 92511 to 96999 and 97802 to 98929 and 99000 to 99199 and 99500 to 99600): CPT Codes 90...
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Related to CHOICECARE NETWORK REIMBURSEMENT

  • Business Expense Reimbursement During the Term of employment, the Executive shall be entitled to receive proper reimbursement for all reasonable, out-of-pocket expenses incurred by the Executive (in accordance with the policies and procedures established by the Company for its senior executive officers) in performing services hereunder, provided the Executive properly accounts therefore.

  • Business Expense Reimbursements During the Term, the Company shall promptly reimburse Executive for Executive’s reasonable and necessary business expenses in accordance with the Company’s then-prevailing policies and procedures for expense reimbursement (which shall include appropriate itemization and substantiation of expenses incurred).

  • Expense Reimbursement The Executive shall be entitled to receive reimbursement for all appropriate business expenses incurred by him in connection with his duties under this Agreement in accordance with the policies of the Company as in effect from time to time.

  • Applicable Reimbursement Level and Term of Reimbursement For the period from August 1, 2016 through July 31, 2017, to the extent that the total annual ordinary fund operating expenses of Class Y shares of any Fund exceeds the total annual ordinary fund operating expenses of the Class A shares of that Fund, IDI and/or WISC agrees to reimburse sufficient Rule 12b-1 fees and/or shareholder servicing fees to ensure that the total annual ordinary fund operating expenses of such Class Y shares do not exceed the total annual ordinary fund operating expenses of the Class A shares of that Fund, as calculated at the end of each month (the “Reimbursement Amount”).

  • Expense Reimbursements To the extent that any reimbursements payable pursuant to this Agreement are subject to the provisions of Section 409A of the Code, any such reimbursements payable to Executive pursuant to this Agreement shall be paid to Executive no later than December 31 of the year following the year in which the expense was incurred, the amount of expenses reimbursed in one year shall not affect the amount eligible for reimbursement in any subsequent year, and Executive’s right to reimbursement under this Agreement will not be subject to liquidation or exchange for another benefit.

  • Reimbursement of Travel Expenses If the Servicer provides access to the Review Materials at one of its properties, the Issuer will reimburse the Asset Representations Reviewer for its reasonable travel expenses incurred in connection with the Review on receipt of a detailed invoice.

  • Cost Reimbursement Retrocessionaire shall reimburse for its allocated share of all costs and expenses incurred by Retrocedant in administering the Reinsurance Contracts as set forth in Exhibit H hereto.

  • Relocation Reimbursement In the event the Company changes the principal place of business at which the Executive performs his duties to a location that is outside of a 50 mile radius of Jenkintown, Pennsylvania, the Company shall reimburse the Executive for all reasonable relocation expenses, including but not limited to, temporary housing for the Executive and his family.

  • Premium Tax Reimbursement The Reinsurer will not reimburse the Ceding Company for premium taxes.

  • Loss Reimbursement Subadviser shall reimburse the Account for any material error to the Fund's net asset value caused by Subadviser's breach of its standard of care, as set forth in the following sentence that is a direct cause of a delay in the accurate daily pricing of the Fund. In managing the Account, Subadviser shall act with the care, skill, prudence and diligence under the circumstances then prevailing that a prudent person acting in a like capacity and familiar with such matters would use in the conduct of an enterprise of a like character and with like aims.

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