Billing for Non-Covered Services. In the event that BCBSTX determines and informs Ancillary Provider that a proposed service is not a Covered Service, including but not limited to services that are determined to be experimental/investigational or not medically necessary. Ancillary Provider must inform the Subscriber in writing in advance of the service being rendered that the service is a non-Covered Service in order to be allowed under this Agreement to xxxx the Subscriber for the service rendered. The Subscriber must also acknowledge this disclosure in writing and agree to accept the service as a non-Covered Service billable directly to the Subscriber. In the event the Subscriber’s benefits are exhausted, Ancillary Provider may continue to provide treatment to the Subscriber if the Subscriber agrees in writing to pay for those services; provided, however, the Ancillary Provider may not charge Subscriber more than the amount allowed as described in Exhibit B.
Billing for Non-Covered Services. (a) In the event that Service Provider provides any Non-Covered Services (or any other services not included within the scope of the Services), Service Provider shall submit an invoice and Owner shall compensate Service Provider for such services per the Billing Rate Schedule in Exhibit D. Third party services will be billed directly to Owner by the applicable third party and shall be paid by Owner directly in a timely manner.
Billing for Non-Covered Services. In the event that BCBSTX determines and informs Medical Group that a proposed service is not a Covered Service, including but not limited to services that are determined to be experimental/investigational or not Medically Necessary, Medical Group must inform the Subscriber in writing in advance of the service being rendered that the service is a non-Covered Service in order to be allowed under this Agreement to xxxx the Subscriber for the service rendered. The Subscriber must also acknowledge this disclosure in writing and agree to accept the service as a non-Covered Service billable directly to the Subscriber. In the event the Subscriber’s benefits are exhausted, Medical Group may continue to provide treatment to the Subscriber if the Subscriber agrees in writing to pay for those services; provided, however, that Medical Group may not charge the Subscriber more than the amount allowed as described in Attachment A.
Billing for Non-Covered Services. Except as otherwise stated herein, Professional Provider may, at all times, bill a Member for services which are not Covered Services. Billing for non-covered services may occur only if Professional Provider has given the Member advance written notice that the service may not be eligible for coverage and an estimate of the cost thereof. Thereafter, the Member must agree in writing to assume financial responsibility for the service in advance of receiving such service. The signed agreement shall be kept in Professional Provider’s records. Non-covered services include those ineligible under the Member’s Plan Documents, deemed experimental or investigational, or deemed not medically necessary by Highmark and/or, as applicable, Health Plan.
Billing for Non-Covered Services. In the event that BCBSTX determines and informs Medical Group that a proposed service is not a Covered Service, including but not limited to services that are determined to be experimental/investigational or not Medically Necessary, Medical Group must inform the Member in writing in advance of the service being rendered that the service is a non- Covered Service in order to be allowed under this Agreement to xxxx the Member for the service rendered. The Member must also acknowledge this disclosure in writing and agree to accept the service as a non-Covered Service billable directly to the Member. In the event that the Member’s benefits are exhausted, Medical Group may continue to provide treatment to the Member if the Member agrees in writing to pay for those services; provided, however, that Medical Group may not charge the Member more than the amount allowed as described in Attachment A.
