Balance Billing Policies
Except for co-payments, deductibles and non-covered services, Participating Physicians, hospitals and ancillary providers may not bill or seek payment from a DMC Care member for services which are either 1) not Medically Necessary or 2) not rendered at an appropriate level of care as determined in accordance with the Utilization and Quality Management Program described in this Manual. Provider may only charge and collect payment from member when member agrees in writing to pay for such services prior to such service being rendered.


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