Maximum Reimbursement Allowance definition

Maximum Reimbursement Allowance. The amount established by The Plan as the maximum amount allowed for Covered Services rendered to Blue Choice PPO Members, as described in Article III.
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Maximum Reimbursement Allowance. The amount established by BlueLincs HMO as the maximum amount allowed for Covered Services rendered to BlueLincs HMO Members, as described in Article IV.
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Maximum Reimbursement Allowance. The amount established by The Plan as the maximum allowed amount for Covered Services rendered to NativeBlue Members, as described in Article III.
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Examples of Maximum Reimbursement Allowance in a sentence

  • The total amount collected from The Plan, or administered accounts, and the Blue Preferred PPO 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 accept as payment in full for Covered Services rendered to Blue Choice PPO Members the lesser of Groups Usual Charge or The Plans Maximum Reimbursement Allowance set forth in Article III and hold Blue Choice PPO Members harmless from any sums in excess of this Maximum Reimbursement Allowance.

  • The basis for reimbursement for Covered Services provided to NativeBlue Members will be the lesser of Group's Usual Charge or The Plan's Maximum Reimbursement Allowance set forth below.

  • Until The Plan has determined the Maximum Reimbursement Allowance and notified Group of the amount due from the NativeBlue Member, if any, under the NativeBlue Member's Benefit Agreement, Group shall not bill or attempt to collect from the NativeBlue Member any coinsurance amounts.

  • Until The Plan has determined the Maximum Reimbursement Allowance and notified Group as to the amount due from the Blue Choice PPO Member, if any, under the Blue Choice PPO Members Benefit Agreement, Group shall not bill or attempt to collect from the Blue Choice PPO Member any coinsurance amounts.

  • This paragraph shall supersede any provision contained in the Agreement, if applicable, to accept the Blue Traditional Maximum Reimbursement Allowance for any Member whose designated network is one in which Group does not participate.

  • Group agrees to accept as payment in full for Covered Services rendered to NativeBlue Members the lesser of Group's Usual Charge or The Plan's Maximum Reimbursement Allowance set forth in Article III and hold NativeBlue Members harmless from any sums in excess of this Maximum Reimbursement Allowance.

  • In the event that Group has not separately contracted with The Plan for its other networks, including but not limited to Blue Preferred PPO, BlueLincs HMO or Blue Advantage PPO, the terms of this Blue Choice PPO Addendum, including the Maximum Reimbursement Allowance described herein, shall be applicable to any Covered Services rendered to a Member whose designated network is one in which Group does not participate.

  • In the event that Group has not separately contracted with The Plan for its other networks, including but not limited to BlueLincs HMO or Blue Advantage PPO, the terms of this Blue Preferred PPO Addendum, including the Maximum Reimbursement Allowance described herein, shall be applicable to any Covered Services rendered to a Member whose designated network is one in which Group does not participate.

  • Group agrees to hold such Member harmless from any sums in excess of the Blue Preferred PPO Maximum Reimbursement Allowance.


More Definitions of Maximum Reimbursement Allowance

Maximum Reimbursement Allowance. The amount established by The Plan as the maximum allowed amount for Covered Services rendered to Members.
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Related to Maximum Reimbursement Allowance

  • Credit allowance date means with respect to any qualified equity investment:

  • NOx Allowance means an authorization to emit a specified amount of NOx that is allocated or issued under an emissions trading or marketable permit program of any kind that has been established under the Clean Air Act or a state implementation plan.

  • Advance Reimbursement Amount has the meaning stated in Section 4.4(b) of the Servicing Supplement.

  • Retirement allowance means the retirement payments to which a member is entitled.

  • Advance Reimbursement Amounts As defined in Section 3.29 hereof.