Common use of Member Responsibility Clause in Contracts

Member Responsibility. If Provider is responsible for seeking prior authorization from UBH or Payor before receiving payment for treatment of emergency medical conditions and a Member is eligible at the time when Covered Services are provided, then the Member shall not be held financially responsible for payment of Covered Services, other than any copayments, coinsurance or deductibles for which Member is responsible under the terms of the Member’s Benefit Plan, if the prior authorization for emergency medical services has not been sought or received.

Appears in 4 contracts

Sources: Individual Participating Provider Agreement, Individual Participating Provider Agreement, Provider Agreement