Verification of Eligibility. ▇▇▇▇▇ shall make available to PROVIDER a system for determining eligibility of Members seeking services under benefit programs hereunder. PROVIDER agrees to comply with the eligibility system requirements and to obtain a valid, confirmation of eligibility number prior to rendering services to any Member. To verify eligibility of Member(s) PROVIDER shall call the appropriate toll-free (800/888) number supplied by ▇▇▇▇▇, or access the ▇▇▇▇▇ website (▇▇▇.▇▇▇▇▇▇▇▇▇▇▇.▇▇▇), or receive from Member(s) a valid pre-certified voucher. In order for PROVIDER to receive reimbursement for services rendered to a Member, services must be provided within the timeframe communicated to PROVIDER upon receipt of a confirmation of eligibility number, or upon PROVIDER’s receipt of an extension of the original confirmation of eligibility number. Neither ▇▇▇▇▇ nor Plan(s) shall have any obligation to reimburse PROVIDER for any services rendered without a valid confirmation of eligibility number. However, if ▇▇▇▇▇ provides erroneous eligibility information to PROVIDER, and if benefits under the program(s) are provided to a Member, ▇▇▇▇▇ shall reimburse PROVIDER for any benefits provided to a Member.
Appears in 10 contracts
Sources: Participating Provider Agreement, Participating Provider Agreement, Participating Provider Agreement
Verification of Eligibility. ▇▇▇▇▇ shall make available to PROVIDER a system for determining eligibility of Members seeking services under benefit programs hereunder. PROVIDER agrees to comply with the eligibility system requirements and to obtain a valid, valid confirmation of eligibility number prior to rendering services to any Member. To verify eligibility of Member(s) PROVIDER shall call the appropriate toll-free (800/888) number supplied by ▇▇▇▇▇, or access the ▇▇▇▇▇ website (▇▇▇.▇▇▇▇▇▇▇▇▇▇▇.▇▇▇), or receive from Member(s) a valid pre-certified voucher. In order for PROVIDER to receive reimbursement for services rendered to a Member, services must be provided rendered within the timeframe communicated to PROVIDER upon receipt of a confirmation of eligibility number, or upon PROVIDER’s receipt of an extension of the original confirmation of eligibility number. Neither ▇▇▇▇▇ nor Plan(s) shall have any obligation to reimburse PROVIDER for any services rendered without a valid confirmation of eligibility number. However, if ▇▇▇▇▇ provides erroneous eligibility information to PROVIDER, PROVIDER and if benefits under the program(s) are provided to a Member, ▇▇▇▇▇ shall reimburse PROVIDER for any benefits provided to a such Member.
Appears in 1 contract
Sources: Participating Provider Agreement
Verification of Eligibility. ▇▇▇▇▇ shall make available to PROVIDER a system for determining eligibility of Members seeking services under benefit programs hereunder. PROVIDER agrees to comply with the eligibility system requirements and to obtain a valid, confirmation of eligibility number prior to rendering services to any Member. To verify eligibility of Member(s) ), PROVIDER shall call the appropriate toll-free (800/888) number supplied by ▇▇▇▇▇, or access the ▇▇▇▇▇ website (▇▇▇.▇▇▇▇▇▇▇▇▇▇▇.▇▇▇), or receive from Member(s) a valid pre-certified voucher. In order for PROVIDER to receive reimbursement for services rendered to a Member, services must be provided rendered within the timeframe communicated to PROVIDER upon receipt of a confirmation of eligibility number, or upon PROVIDER’s receipt of an extension of the original confirmation of eligibility number. Neither ▇▇▇▇▇ nor Plan(s) shall have any obligation to reimburse PROVIDER for any services rendered without a valid confirmation of eligibility number. However, if ▇▇▇▇▇ provides erroneous eligibility information to PROVIDER, and if benefits under the program(s) are provided to a Member, ▇▇▇▇▇ shall reimburse PROVIDER for any benefits provided to a Member.
Appears in 1 contract
Sources: Participating Provider Agreement
Verification of Eligibility. ▇▇▇▇▇ shall make available to PROVIDER a system for determining eligibility of Members seeking services under benefit programs hereunder. PROVIDER agrees to comply with the eligibility system requirements and to obtain a valid, confirmation of eligibility number prior to rendering services to any Member. To verify eligibility of Member(s) PROVIDER shall call the appropriate toll-free (800/888) number supplied by ▇▇▇▇▇, or access the ▇▇▇▇▇ website (▇▇▇.▇▇▇▇▇▇▇▇▇▇▇.▇▇▇), or receive from Member(s) a valid pre-certified voucher. In order for PROVIDER to receive reimbursement for services rendered to a Member, services must be provided rendered within the timeframe communicated to PROVIDER upon receipt of a confirmation of eligibility number, or upon PROVIDER’s receipt of an extension of the original confirmation of eligibility number. Neither ▇▇▇▇▇ nor Plan(s) shall have any obligation to reimburse PROVIDER for any services rendered without a valid confirmation of eligibility number. However, if ▇▇▇▇▇ provides erroneous eligibility information to PROVIDER, and if benefits under the program(s) are provided to a Member, ▇▇▇▇▇ shall reimburse PROVIDER for any benefits provided to a Member.
Appears in 1 contract
Sources: Participating Provider Agreement