Negotiated National Account Arrangements Clause Samples

Negotiated National Account Arrangements. As an alternative to the BlueCard Program, Member claims for covered health care services may be processed through a negotiated national account arrangement with a Host Plan. If Blue Cross and Blue Shield has arranged for Host Plans to make available custom provider networks in connection with this Agreement, then the terms and conditions set forth in Blue Cross and Blue Shield’s negotiated national account arrangements with those Host Plans will apply. The calculation of a Member’s liability on claims for covered health care services received outside of Massachusetts and processed through a negotiated national account arrangement will be based on the provider’s actual charge or the negotiated price (allowed charge), whichever is less. If Blue Cross and Blue Shield enters into a Negotiated National Account Arrangement with a Host Plan to provide Value-Based Programs to your Members, Blue Cross and Blue Shield will follow the same procedures for Value-Based Programs administration as noted in the BlueCard Program section. Blue Cross Blue Shield Global® Core Blue Cross Blue Shield Global Core and Members’ health care benefits for non-participating providers are fully described in the Subscriber Certificates for your benefits plans. When Members receive covered health care services outside the United States, Puerto Rico, and the U.S. Virgin Islands, there is no available geographic area served by a Host Plan. In these instances, Members may be able to use Blue Cross Blue Shield Global Core to access non-participating providers. Blue Cross and Blue Shield also participates in the Inter-Plan Medicare Advantage Program, the Inter-Plan Program for Members enrolled in a Medicare Advantage plan. In the event you elect to offer a Medicare Advantage plan to your Medicare-eligible Members, when Medicare Advantage Members access health care services outside of Massachusetts, the claim for those services will be processed through the Inter-Plan Medicare Advantage Program and presented to Blue Cross and Blue Shield for payment in accordance with the rules of the Inter-Plan Medicare Advantage Program policies then in effect. The Inter-Plan Medicare Advantage Program available to Members under this Agreement is described generally as follows. The cost of the covered health care service on which a Member’s cost share liability (such as coinsurance) is based will be either: • The Medicare allowable charge for covered services, or • The amount the Host Plan negotiates with it...
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Negotiated National Account Arrangements. As an alternative to the BlueCard Program, Member claims for covered health care services may be processed through a negotiated national account arrangement with a Host Plan. If Blue Cross and Blue Shield has arranged for Host Plans to make available custom provider networks in connection with this Agreement, then the terms and conditions set forth in Blue Cross and Blue Shield’s negotiated national account arrangements with those Host Plans will apply. The calculation of a Member’s liability on claims for covered health care services received outside of Massachusetts and processed through a negotiated national account arrangement will be based on the provider’s actual charge or the negotiated price (allowed charge), whichever is less.
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Negotiated National Account Arrangements. As an alternative to the BlueCard Program, BCBSNE may enter into a Negotiated National Account Arrangement with a Host Blue. Under such arrangements, any fees charged will not be greater than the comparable fees that would have been charged under the BlueCard Program. BCBSNE will charge these fees as follows:
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Negotiated National Account Arrangements. As an alternative to the BlueCard Program, your Enrollee claims for covered healthcare services may be processed through a negotiated National Account arrangement with a Host Blue. If BCN and Group have agreed that a Host Blue(s) shall make available a custom healthcare provider network(s) in connection with this contract, then the terms and conditions set forth in BCNS’s negotiated National Account arrangement(s) with such Host Blue(s) shall apply. In negotiating such arrangement(s), BCN is not acting on behalf of or as an agent for Group, the Group’s health care plan(s), or Enrollees. Group agrees that BCN will not have any responsibility in connection with the processing and payment of claims when Enrollees access such network(s), except as may be set forth in the relevant participation agreement. Enrollee liability calculation will be based on the negotiated price/lover of either billed covered charges or negotiated price made available to BCN by the Host Blue that allows Group’s Enrollees access to negotiated participation agreement networks of specified participating healthcare providers outside of BCN’s service area.
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Negotiated National Account Arrangements. If Anthem Blue Cross Life and Health has entered into a Negotiated National Account Arrangement with a Host Blue to provide Value-Based Programs to Members, Anthem Blue Cross Life and Health will follow the same procedures for Value-Based Programs administration and Care Coordination Fees as noted in the BlueCard Program section.
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Negotiated National Account Arrangements. As an alternative to the BlueCard Program, claims for covered healthcare services may be processed through a negotiated national account arrangement with a Host Blue. If BCBSNC has arranged for a Host Blue to make available a custom healthcare Provider network in connection with this contract, then the terms and conditions set forth in our negotiated national account arrangement with such Host Blue shall apply. Member liability calculation will be based on the negotiated price (Refer to the description of negotiated priced under Section a.(i) Liability Calculations Method Per Claim, above) made available to BCBSNC by the Host Blue that allows the Members access to negotiated participation agreement networks of specified participating healthcare Providers outside of BCBSNC’s service area.
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Related to Negotiated National Account Arrangements

  • Deposit Account Transactions (a) The Bank or its Subcustodians will make payments from the Deposit Account upon receipt of Instructions which include all information required by the Bank. (b) In the event that any payment to be made under this Section 5 exceeds the funds available in the Deposit Account, the Bank, in its discretion, may advance the Customer such excess amount which shall be deemed a loan payable on demand, bearing interest at the rate customarily charged by the Bank on similar loans. (c) If the Bank credits the Deposit Account on a payable date, or at any time prior to actual collection and reconciliation to the Deposit Account, with interest, dividends, redemptions or any other amount due, the Customer will promptly return any such amount upon oral or written notification: (i) that such amount has not been received in the ordinary course of business or (ii) that such amount was incorrectly credited. If the Customer does not promptly return any amount upon such notification, the Bank shall be entitled, upon oral or written notification to the Customer, to reverse such credit by debiting the Deposit Account for the amount previously credited. The Bank or its Subcustodian shall have no duty or obligation to institute legal proceedings, file a claim or a proof of claim in any insolvency proceeding or take any other action with respect to the collection of such amount, but may act for the Customer upon Instructions after consultation with the Customer.

  • Transactions in Foreign Custody Account (a) Except as otherwise provided in paragraph (b) of this Section 3.8, the provision of Sections 2.2 and 2.7 of this Contract shall apply, mutatis mutandis to the foreign securities of the Fund held outside the United States by foreign sub-custodians. (b) Notwithstanding any provision of this Contract to the contrary, settlement and payment for securities received for the account of each applicable Portfolio and delivery of securities maintained for the account of each applicable Portfolio may be effected in accordance with the customary established securities trading or securities processing practices and procedures in the jurisdiction or market in which the transaction occurs, including, without limitation, delivering securities to the purchaser thereof or to a dealer therefor (or an agent for such purchaser or dealer) against a receipt with the expectation of receiving later payment for such securities from such purchaser or dealer. (c) Securities maintained in the custody of a foreign sub-custodian may be maintained in the name of such entity's nominee to the same extent as set forth in Section 2.3 of this Contract, and the Fund agrees to hold any such nominee harmless from any liability as a holder of record of such securities.

  • Deposit Account Control Agreements the Deposit Account control agreements to be executed by each institution maintaining a Deposit Account for an Obligor, in favor of Agent, for the benefit of Secured Parties, as security for the Obligations.

  • Deposit Accounts; Credit Card Arrangements (a) Annexed hereto as Schedule 5.21(a) is a list of all DDAs maintained by the Loan Parties as of the Closing Date, which Schedule includes, with respect to each DDA (i) the name and address of the depository; (ii) the account number(s) maintained with such depository; (iii) a contact person at such depository, and (iv) the identification of each Blocked Account Bank. (b) Annexed hereto as Schedule 5.21(b) is a list describing all arrangements as of the Closing Date to which any Loan Party is a party with respect to the processing and/or payment to such Loan Party of the proceeds of any credit card charges and debit card charges for sales made by such Loan Party.

  • Custody Account Transactions (a) Securities will be transferred, exchanged or delivered by the Bank or its Subcustodian upon receipt by the Bank of Instructions which include all information required by the Bank. Settlement and payment for Securities received for, and delivery of Securities out of, the Custody Account may be made in accordance with the customary or established securities trading or securities processing practices and procedures in the jurisdiction or market in which the transaction occurs, including, without limitation, delivery of Securities to a purchaser, dealer or their agents against a receipt with the expectation of receiving later payment and free delivery. Delivery of Securities out of the Custody Account may also be made in any manner specifically required by Instructions acceptable to the Bank. (b) The Bank, in its discretion, may credit or debit the Accounts on a contractual settlement date with cash or Securities with respect to any sale, exchange or purchase of Securities. Otherwise, such transactions will be credited or debited to the Accounts on the date cash or Securities are actually received by the Bank and reconciled to the Account. (i) The Bank may reverse credits or debits made to the Accounts in its discretion if the related transaction fails to settle within a reasonable period, determined by the Bank in its discretion, after the contractual settlement date for the related transaction. (ii) If any Securities delivered pursuant to this Section 6 are returned by the recipient thereof, the Bank may reverse the credits and debits of the particular transaction at any time.