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obtaining written Member consent. Neither Company nor Payor shall be liable for any health care services or supplies which are determined by Company, Payor or their designee to be a Non -Covered Service; however, the Member may be liable for Non -Covered Services subject to the terms set forth in Sections 3.9.2 through 3.9.4 herein. In no event will Company or Payor be responsible for any amount owed by Member to Medical Group for Non -Covered Services in the event that Medical Group is unable to collect such amount from Member. 3.9.2 Medical Group may bill a Member for services or supplies determined by Company or its designee to be not Medically Necessary only if Medical Group has obtained appropriate Member consent in writing. At a minimum, the written Member consent must include the following information: Member name; specific service or supply; date of service, if known; a statement informing the Member that the service or supply may be a Non -Covered Service; and a statement where the Member agrees to pay for the Non -Covered Service. The written Member consent must be signed by the Member, Member's guardian or Member's authorized health care representative and maintained in Medical Group's records. Medical Group agrees to write off and not charge Company, Payor or Member any amount owed for not Medically Necessary services or supplies if Medical Group fails to obtain such written consent. 3.9.3 For services rendered to Members enrolled in Medicaid that are determined by Company or Payor to be Investigational, Medical Group must obtain the written Member consent as described in the Healthy Options Administrative Manual before rendering services in order to charge the Member for the services. If Medical Group fails to obtain such written Member consent, Medical Group agrees to write off and not charge Company, Payor or Member for such Investigational services. For all other Members receiving services that may be deemed Investigational by Company or Payor, a written Member consent is not required in order to charge Members for such services. However, Company still encourages Medical Group to inform Member before services are rendered that such services may be deemed Non -Covered Services by Company or Payor, and that if the services are deemed Non -Covered Services the cost of such services will be the responsibility of the Member. 3.9.4 Services or supplies provided to Members after they have exhausted their annual or lifetime benefit for such services as provided in the Subscriber Agreement shall no longer be subject to the terms of this Agreement, except for the claim or claim line (as applicable) that results in the benefit maximum to be exceeded. For that claim or claim line (as applicable), Medical Group agrees that any balance billed to the Member shall be the lesser of billed charges or the allowed amount under this Agreement less any amount paid by Company or Payor. The "claim line" language is applicable where services or supplies are paid individually. The "claim" language is applicable for services paid based on an episode of care. 3.9.5 Medical Group shall not bill Members for Covered Services (except for deductibles, copayments or coinsurance) where Company or Payor denies payment because Medical Group has failed to comply with the terms of this Agreement. 3.10 INELIGIBLE MEMBERS — Company is not obligated to make payment to Medical Group for services provided to an individual who is not, at the time such services are received, a duly eligible Member. The fact that an individual possesses an identification card will not obligate Company to pay or provide services if on the date(s) that such services were rendered, the individual is, or is later to have found to have been, ineligible for medical benefits, except in cases where the Company has provided prior authorization to the Medical Group for a requested service. Authorization by Company for a requested service does not guarantee that the Member is eligible or will continue to be eligible for Asuris MGA Agreement (Rev. 05/2017) A18816854AA Page 8 of 20