Common use of Accept Reimbursement Clause in Contracts

Accept Reimbursement. Group agrees to accept as payment in full for Covered Services rendered to Members the lesser of Group's Usual Charge or The Plan's Maximum Reimbursement Allowance set forth in Article V and hold Members harmless from any sums in excess of this Maximum Reimbursement Allowance. Group may collect from the Member any amounts for Noncovered Services and the applicable copayment and deductible unless prohibited by law. Until The Plan has determined the Maximum Reimbursement Allowance and notified Group as to the amount due from the Member, if any, under the Member's Benefit Agreement, Group shall not bill or attempt to collect from the Member any coinsurance amounts. The total amount collected from The Plan, or administered accounts, and the Member for copayment, deductible, and coinsurance, but not including Noncovered Services, may not exceed the lesser of Group's Usual Charge or The Plan's Maximum Reimbursement Allowance. Group agrees to promptly refund to the Member any amounts which may have been collected from the Member in excess of the Member's responsibility as shown on The Plan's provider claims summary.

Accept Reimbursement. Group agrees to accept as payment in full for Covered Services rendered to Members the lesser of Group's ’s Usual Charge or The Plan's ’s Maximum Reimbursement Allowance set forth in Article V and hold Members harmless from any sums in excess of this Maximum Reimbursement Allowance. Group may collect from the Member any amounts for Noncovered Services and the applicable copayment and deductible unless prohibited by law. Until The Plan has determined the Maximum Reimbursement Allowance and notified Group as to the amount due from the Member, if any, under the Member's ’s Benefit Agreement, Group shall not bill or attempt to collect from the Member any coinsurance amounts. The total amount collected from The Plan, or administered accounts, and the Member for copayment, deductible, and coinsurance, but not including Noncovered Services, may not exceed the lesser of Group's ’s Usual Charge or The Plan's ’s Maximum Reimbursement Allowance. Group agrees to promptly refund to the Member any amounts which may have been collected from the Member in excess of the Member's ’s responsibility as shown on The Plan's ’s provider claims summary.