Loading...
HomeMy WebLinkAbout96-02166 ~\ I ) , ~ " , ' .f ,JlJiV ~1f#'Tr . ~~r,', i'.'- .I " ~ J I .;:( . ",,' STEFANON a GLACE A1TORNRYS AT LAW 407 NO~nt PRONT STREET POST OI'PlCE BOX 12027 HARRISBURG. PENNSYI.VANIA 17108.2027 ORJGINAL -_.~,., ....._--,-~............----.--........,. . JAMES L. GEARY Plaintiff : IN THE COURT OF COMMON PLEAS : CUMBERLAND COUNTY PENNSYLVANIA I v. KEYSTONE HEALTH PLAN CENTRAL INC. t/d/b/a KEYSTONE HEALTH PLAN CENTRAT., NO. q" -..J./(.,- CIVIL ACTION LAW Defendant : JURY TRIAL DEMANDED PRAECIPE FOR ISSUANCE OF WRIT OF SUMMONS TO THE PROTHONOTARY: Issue a Writ of Summons against the Defendant Keystone Health Plan Central, Inc. t/d/b/a Keystone Health Plan Central and deliver that Writ to the Sheriff for service upon the Defendant at the address set forth below: KEYSTONE HEALTH PLAN CENTRAL, INC. t/d/b/a KEYSTONE HEALTH PLAN CENTRAL 300 Corporate Center Drive Suite 602, P.O. Box 898812 C..p Hill, PA 17089-8812 By An hony STEFANO 825497 407 No Streot P.O. Box 12027 Harrisburg, PA, 17108-2027 (717) 232-0511 DATE: ~-2~-9~ " " j' - " . . . ., , , " , ,.\ ,\..' . : ''1 p ..{Q, "T" {0) r> I .,., r'," '..~ ~ ,'-..:: ,., l~ 0'" .'j ~ '. ) ......., Crt ,1'1" ~ ~ ..- 0 ,; ~ < ~"\ .,;" ~ .. ..(j, "'-l ~ 1\' W }> --, "< Commonwealth of Pennsylvania County of Cumberland JHml L. GPMY w. Court 01 Common Pleu , 96-2166 Civil Term No, n.__.._n__......___................ 19.... Civil Action - Law In ._____.______________~____._~__~___________._ KEYS'<<R HEALTH PLAN COO'RAL DC. t/d/b/a KEYS'roNE I/ElU1rn PLAN cmrRAL 300 Corporate Center Drive Suite 602. P.O.Box 898812 CaDp Hill, PA 17089-8812 To !<!l.xl!!9!!.E!_tl~!1.~!tu~~~!U~~~!f.l!!.ll'!.<:::J_.1OLd/b/a Keystone Health Plan Central You are hereby notified thaI' ..__JiuDi8-~..Ge<u>y.--.._____.._._______._.._...__...._...__.___.___..___.._.._._............... the Plain rill h.s commenced an action in _.___.<;:!.yH..'~g!LC2I:L.:-._~!!I_..___....... ..__............ against you which you are required to de/end or . delaull judgmenl may be entered aplnll you. (SEAL) r~wrence E. Welker ..,.. .........n.._.... --..... ";;th~~~~';:".""""""""'. ....... Dale ...~~!!..~~.__._._......_... t9__~~ By _k.L.J.J.....{..~.I! {;'.~" I..~.....r~i/. . Dep~'" . ( -',.. H~~~~~I n hg~~1 ~ . . f-' . C. ~. ?jl p~ ;5. f ~2!!~~~ ~ ~l r '."'] .......fl'j I:"' I\) II-' 0 0. . ,... '''''1\) d '" J NUl N R'lrt INo ~'Sl ~ ~ '" U1,.... 011 III g i~:<l hr ~ ~,... I\) r" - n ~ ~~~ ~ I ~p~ r . ~ i Ii oCY:. ~ ,... E1' I'" ~ hr ~ If '" '1 ~~~. II 0 I\) r -.J i' 1,' "I I"~ 1,', " 't' " " 1.:1. :il I.. I '"I' I' i " I I, I .' , , , " I : ), " .11'L , " " I , ",;1 I' I " " I i',1 .11\ I I '1, i I , I i.- 'ji I' \"i 1 I 1 i I, 'I. I, " I :11 ., 'i, I I " ! I,; ': .. I" I , ,. " " 1'0, 'I I "I'. , 1 I , , , I' I. I ", -i, : " /,r; ! ! .. ,i. , hI! , .1 , ! I' , ii' I , : ',,: ,r'"~~~<~!~~ .'il,. I J I /. ~ ' I ~-~ ~ ...... ~& yt!: 11t~ " , , 9(, g"1L<-- c., hu.i...... ) ~P.7 "" . . . . JAMEEI L. GEARY Plaintiff I IN THB COURT OF COMMON PLEAS I CUMBERLAND COUNTY PENNSYLVANIA . . v. Defendant I I NO. 96-2166 I I CIVIL ACTION LAW I JURY TRIAL DEMANDED KEYSTONE HBALTH PLAN CENTRAL INC. t/d/b/a KEYSTONE HEALTH PLAN CENTRAL, NOTICE YOU BAVE BBlN SUBD IN COURT. If you wish to defend against the claims set forth in the following pages, you must take action within twenty (20) days after this Complaint is served, by entering a written appearance personally or by attorney and filing in writing with the Court your defenses or objections to the claims set forth against you. You are warned that if you fail to do so the case may proceed without you and a judgment may be entered against you by t.he Court without further notice for any money claimed in the Complaint or for any other claim or relief requested by the Plaintiff. You may lose money or property or other righte important to you. YOU SHOULD TAXB THIS PAPER TO YOUR LANYBR AT ONCI. IF YOU DO NOT BAVI A LAWYER OR CANNOT AFFORD ONII, 00 TO OR TILJ:PHONII THI OFFICE SIT FORTH BBLOW TO rIND OUT HIlER!: YOU CAR GIT LJ:GAL HILP. Court Administrator 4th Floor Cumberland County Courthollse 1 Courthouse Square Carlisle, PA 17013 1 . " . . . . into by and between Defendant and Plaintiffs' employer. 5. The terms and conditions of the aforesaid health insuranoe plan are set forth in the Subscriber Agreement, a true copy of which Agreement is attached hereto as Exhibit "A". 6. On April 8, 1993, Plaintiff was involved in a motor vehicle collision in which he suffered personal injuries, and for which injuries he received care and treatment during the ensuing month~ and years. 7. At the time that the motor vehicle collision occurred, Plaintiff was insured under a motor vehicle insurance policy issued by Erie Insurance Group, which insurance policy proviried first party benefits for medical expense up to a limit of $10,000.00. 8. During the course of Plaintiff's care and treatment, Plaintiff received rehabilitation and physical therapy through a company known as Occupational Rehab and Research Associates, Inc., located in Harrisburg, Dauphin County, Pennsylvania. 9. Erie Insurance Company paid for Plaintiff's rehabilitation up through the end of April 1994, at which time the $10,000.00 limit of medical benefits under the motor vehicle insurance policy was reached. 10. From May 2, 1994 through August 31, 1994, Plaintiff continued to receive rehabilitation through Occupational Rehab and Research Associates, Inc., whioh company billed Plaintiff for thome services in the total amount of $4,836_00. 11. Occupational Rehab and Research Associates, Inc., as the provider of services to Plaintiff, submitted its claim for payment 4 J . . . to Defendant. 12. Defendant denied responsibility for the expenses incurred by Plaintiff for treatment by Occupational Rehab and Research Ilssociates, Inc., and Plaintiff received an Explanation of Benefits from Defendant, reciting that denial. A copy of that docum~nt is attached hereto as Exhibit "B". 13. Plaintiff requested a reconsideration of this denial, and in relllponse to that reconsideration request received a letter dated June 22, 1995 wherein Defendant stated that the reason for the denial was that the services were not authorized by Plaintiff's Primary Care Provider. A true copy of that letter is attached hereto aa Exhibit "C", 14. At the time that the disputed services were provided to Plaintiff, Plaintiff's Primary Care Provider was Vernne W. Greiner, D.O. . 15, On July 11, 1995, Dr. Greiner addressed a letter to Keystone Health Plan Central wherein he stated that the therapy received by Mr. Geary was both appropriate and required, subsequent to the surgical procedure which Mr. Geary had undergone. A true copy of that letter is attached hereto as Exhibit "0". 16. Plaintiff, acting through counsel, submitted an initial grievance letter dated July 21, 1995, incorporating Dr. Greiner's letter dated July 11, 1995. A true copy of that initial grievance letter is attached hereto as Exhibit "E". 17. By letter dated September 8, 1995, Defendant again denied coverage for the disputed claims. A true copy of that letter is 5 . 4 .. attached hereto as Exhibit "F". COUNT I Breach of Contract 18. The averments of the foregoing paragraphs 1 th1'ough 17 are incorporated herein by reference. 19. Pursuant to the terms and conditions of the Subscriber Agreement, all conditions precedent to Defendant's obligation to pay for the medical expense.. incurred by Plaintiff have been satisfied. 20. The care and treatment received by Plaintiff was authorized by Plaintiff's Primary Care Physician as evidenced by the letter of Dr. Greiner dated July 11, 1995. 21. Pursuant to the terms and conditions of the Subscriber Agreement, Defendant is obligated to satisfy the claims of Occupational Rehab and Research Associates, Inc. in the total amount of $4,836.00. 22. Plaintiff has demanded payment of the claims and Defendant has failed and refused to pay. WHEREPORE, Plaintiff demands judgment against Defendant Keystone Health Plan Central, Inc., t/d/b/a Keystone Health Plan Central in the amount of $4,836.00 plus interest and cost of suit. 6 ~ f: :', II' ~ ' , . . , , ~t " 'f.l\:'~ : '~.- '.\,' . J J . , COURT II Bad raitb 23. The averments of the foregoing paragraphs 1 through 22 are incorporated herein by reference. 24. Defendant's initial denial of benefits was based on the theory that the services were not authorized by Plaintiff's Primary Care Physician. 25. By letter dated July 11, 1995, Plaintiff's Primary Care Physician notified Defendant that the services were, in fact, authorized by him. 26. Despite receipt of that authorization both from the Primary Care Physician and from counsel on behalf of Plaintiff, Defendant persistad in its denial of the benefits sought by Plaintiff. 27. Defendant has no reasonable grounds to deny the claim. 28. Plaint.iff has sought informal reconsideration and review of the denial, and has provided full documentation to Defendant of the reasons why Defendant's denial is unjustified. 29. Despite these informal efforts by Plaintiff, Defendant has persisted in its denial, thereby requiring Plaintiff to file this action in order to enforce Defendant's obligation to Plaintiff. 30. Defendant's conduct in continuing to deny the insurance benefits to Plaintiff is wrongful, willful, and an exercise in bad faith under the provisions of 42 PA C.S.A. S 8371. 7 " . . WBIRBFORl, Plaintiff demands judgment against Keystone Health Plan Central, Inc., t/d/b/a Keystone Health Central for damages in the amount of $4,836.00, plus interest, costs of suit, attorney's fees, and punitive damages as authorized by statute. B Street 17108-2027 DATEr lo.g~ ?~ 8 . .. . I VIRIFXCATX011 , ' I The undersigned hereby verifies that the facta averred in the foregoing Complaint are true and correct to the best of hi. knowledge, information and belief. This Verification is made subject to the penalties of 18 Pa C.S.A. S 4904 relating to unsworn falsification to authoritie.. , \ . , ~...\ ~ 91..- __ (/ JAMES L. GBARY C 'II DATE I /tJ/7 /~~ .. , ,.t. I ," ,:i . 'I;, .\ Iiii' \~ ';'" .\ I 9 '4..11. , .~"I', , '.' , . . . Keystone II Health Plant!>' An~~p~~I~~~lc.nS8e of Inll Blue . CIQ61l lIna BIIJIJ Shutld AS6OClatlOn " Subscriber Agreement IMPORTANT Benefits described in this agreement are covered only when provided or authorized by the primary care physician. ~W!5 &tilt' Y " -"., @' .. Capital Blue Cross Pennsylvania Blue Shield IndeplIndel,ll.lcenSlle" of lh" . . Blue CIOIlK iJJliJ Sluu Sl"llal(j As,c)clllllon Ifl R~181I:lffl\!1 Mil".' ollhIJ 81tH! CIQS5 and Bhle Shield ASElOCllitlon, ;In Aa5uCloltlon nllrll/!:pt?r)tll'.";! Bluu CrO!i8 IUlll Blue Shlold PlAns KC!1;!O '11j<l 'I', {: II" ~~ ,'. ""..... .... ...j, ........... -'......,. 10, !NCOUNTER FORM meens the w""en report sUbm,hsd 10 ~HP Centrel on e form proYlded by ~HP Centrll on which 811 CI3\t'ered Services pro\t'lded to Members by th. Primary Cere PhysIcIan ere identified 11 !NROLLMENT FORM melns Ihe properly compleled, written request for membership or enrollm.nt submitted on I form proYlded by ~HP Cenlral, logelher wllh Iny emendments or modifications thereof 12.EQUIVALENT PARTIAL SESSION VISIT . A YI'" consisting of 8 period of 20-30 minutes devotea to Indl\t'ldual or family medical psychotherapy for the treatment of problems 'elated to lSubstance abuse, With continuing medical diagno$tlc e\t'lIluatlon, and drug management when Indicated, to Inr.lude IndiVidual psychoanalysts, inSight oriented, bel,a\t'lor mOdifying or supportive Psychotherapy Two Equl\t'Blent Partial Sessions equal one F-'uH Sesllon VIOIt 13, EXPERIMENTAUINVESTIGATlVE - Thl use 01 any treatment, procedure, faCility, equipment, drug, or drug uSlgl doYlce or supply which KHP Cenlra', relYing on Ihe advicl'J of the general medical community whIch Includes but il not Umited to medical consultants, medics I Journals and/or go\t'ernmental regulations does not accept as standard medical treatment of the conditIon being treated, or itny such Items requlrtng federal or oth.r governmental agency appro\t'al which approval has not been granted at the time the 5l!rylt:es were rlndered 14 FULL SESSION VISIT. A YI51t cons..llng of a period 01 45~50 mInutes devoted to indiVidual or famIly medical psycholherlpy lor Ihe lrellmlnt 01 problem, related 10 substance abuse, wilh continuing medlcol dIagnostic l\t'alu8tlon, and drug management when Indicated, to Include Indl\t'ldual psychoanalysIs, InslQht oriented, beha\t'lor modifying or supportIVe psychotherlpy 15 GROUP . Tha party enle"ng Into a conlrael wllh KHP Central on behalf of the Members. including the employer or representstl\t'e of and remitting agent 'or the Members who collects and remits premIum peyments on behal' of the Members 16 GROUP CONTRACT means an agreement between KHP Central and ~ Group pursuent to whIch KHP Cantrsl coverlJge under thiS or other applicable KHP Cenlral SubSCriber Agreement 15 made available to persons eligible to enroH In KHP Central's programs 17 GROUP OPEN ENROLLMENT PERIOD "'eans those perIods or tIme established by the Group and KHP Central from time to tlmo, but no less fre~uentJy than once In any 12 consecutive months, during which eltglbl& parsons who have not pre\t'lously enroUed wllh KHP Central may do 50 2 ~ ,'. 18 HOME HEALTH AGENCY Is In orglnlzlllon licensed by Ihe Commonwealth of PennsylvanIa to render home h..lth care Servlc.1 to Members 19 HOSPIC! CARE. Custodlll clre rendered to e lermlnally III member WIth 8 life expectancy of SIX (6) months or Ie.. ~O HOSPITAL . Iny Inslllullon duly IIclnsed, certlned and operlled as e Hospllal In no ..ent ShIll the lerm Hospltel ulclude a con\t'alescent faCility, nursIng home, or any institution or plrt thereof which. is used as a convalescent. rlClllty, rest IIClllty, nursing Ilc,lIty or Ilcll,ty for Ihe eged 21 HOSPITAL SERVICES (excepl es limited or e.cluded herein) are those acute-clre Co\t'ered Servlc.. furnished by I Hosplll' or Skilled Nurs,ng Faclllly which Ire eutho"zld by I KHP Cenlrll Prlmery Clre Phys,clln end set forth In ArtlC11 II, Ben ems 22 INFERTILITY . The diminished or Ibsent clpeclly to produce offspring regardless of underlying CIUGe, Including but net limIted to diminIShed or absent capacIty to concel\t'e 23 INPATIENT melns a Memblr who Is Idmlhed IS I bed pollenl In I Hosplla', a Rehablllllllon Hospllal, I Skilled Nursing Facility or 0 Substance Abuse Treatment FaCIlity 24 KEYSTONE HEALTH PLAN CENTRAL IKHP Cenlrellls I health maintenance organization Which arranges (or the provIsion at Co\t'ered Services to Members In a KHP Central Service Ares 25 MEDICAID melns Hosp,lal or medical Insurance benems provided by the UnIted States Go\t'ernment unc.:ler Titl. XIX 01 the SOCial Security Act 01 1985, a. amended 26 MEDICAL DIRECTOR meln. a physlc'"n designated by KHP Central to monitor appropriate utilization and quality at covered services rocelved by Members 27 MEDICALLY NECESSARY OR M!DICAL NECESSITY means tho appropriate and necessary Covered S.rvlcea as determined by the Primary Care Physictan and KHP Central which are rendered by a Pro\t'lder to a Member for a condition requiring, according to generally. accepted prinCiples of good medical practice, the diagnOSIs or dIrect care treatment of an Illness or Injury and which are not prOVided only as a convenience 28 MEDICARE means HosPltcil or medical Insurance benefits pro\t'lded by the IJnlted States Go\t'ornm.nt under TiUe XVIII of the SOCial Security Act of 1965, as amended 1 29. MEMBER moana I,' IndlYldual who IS contrlctullly Inlltlld to "CIIYO Cove"d SI",'clI .".ngld by KHP Clnlr.1 undor Ihls Agr.lmlnt 30 OUT OF AREA SERVICES .r. tho.. COYI"d SI""CII prOYldld oull'dl KHP Clnlr.l'. S'''''CI Aru COyorld Servlces ar. limIted to Emergency Services and Covered ServIces that 8re .rrBnged or lutho(lz.d by a I<HP Central Primary Clr. PhYSician and/or the KHP Central MedIcal Director 31 OUTPATIENT meln. a Momber who reCIIY.. Covered Services or OUppJIe& while not an Inpot,ent 32, PARTIAL HOSPITALIZATION mo.n. the proYlslon of medIcal, nursing. counseling or therapeutIC Covered Services on lJ planned and regulqrly scheduled baSIS in a faCility licensed I:IS 8 substance abuse treatment program by the Department of Helllth, deSIgned for a patient or client who would benefit from more IntenSive Covered ServIces that afd ottered In Outpatient treatment but who does nof require Inpatient care 33 PARTICIPATING PROVIDER me.ns a phy.,c,.n, .lIled hellth prof..Slon.I, HOSPlt." Skilled NurSing FaCility, Rehabllltetlon Hospital, Horn. Healtl' Agency, or Bny other health care lnltltutlon or practitioner, hcenud by the Commonwealth at Pennsylvsnlll, With which KHP Central h81 arranged to prO\/lde CO\lered Services to Members 34 PRIMARY CARE PHYSICIAN me.ns a duly licensed doctor at medlc;ne or osteopathy who hal a contract With KHP C.ntral under thil Agreement to supeNlIsI, coordinate and provide hllllSI and beslc care 117 members, Initiate their re'erral for a spectallst care and mamtaln continuity at pat/flnt care 35, REHABILITATION HOSPITAL 's a f.c,I,ly Provld.r which IS engaged In prOViding rehabilitation Services on an InpatIent basts 36 REIMSURSEMEIJT VALUE me.ns the .mounl ch.rged or the amount KHP Central has e)(pended for a particular h.alth UNlee In the geographical area In which It 15 performed 37 SERVICE AREA rrleans the geographical areas as approved by the State wllhln which KHP Central imanges for prOVISIon of Covered Services 10 Members 38 SKIL\.ED NURSING FACI\.ITV . An ,n",tutlon. ur a d'stlnct part of an institution, faCIlity, rest raclllty, or faCility ror the aged, which IS licensed as a S~llIed NurSing FaCility by Ihe Commo~w8alth 0' Penn,ylvanla and approved by KHP Central 4 ~ 39 SUBSCRIBER mlln. I Member who.1 Imploymlnl or othor stllu" exclpt for f.mlly dopln~.ncy, ,. th. b..l. 'or IlIg,blllty 'or Inrollmlnlln KHP C.ntrll 40 SUBSCRIBER DATA CHANGE FORM mlln. I form upon which the wrltt.n lut'million to KHP Centr,' of ching.. In Subscriber dltl .".clIn~ Member eligibility II mlde. Thl. 'arm may bl obl.'ned from the employer or directly from KHP Clntrll 41 SUBSTANCE ABUSE . The u.. of "'cohol or other addlctlye drugs which produces . pl~ern of plthol09,cl' use c8uslng Impairment In soclel or OCCup8ltQnll functionIng or wh'ch produces phtllolog,c.1 d.pend.ncy IVldenced by phy.lcaltoler.ncl or wlthdrlw.l. Drugs sh.1I bl dlfined .s addlcllYe drugl end drugs of Ibuse listed IS schedule~ drugs in the P.nnsyly.nl. Conlroll.d Subsllnces, Drug, DeVice and Cosmtittc Act 42 3UBSTANCE ABUSE TREATMENT FACILITY. A flclllty PrOY,der which IS Iicen.ed by tho Dep.rlment of He.,th .nd approved by thl Joint Commls.lon on thl Accredllltlon of Hosplt.ls and by KHP Centrll or Its deslgnla which .. prlm."ly eng.gld In proYld,ng Dltoxlficltlon Ind/or rehabilitation treatment for alcoholism and/or drug abuse ARTICLE II . BENEFITS Subject to the lerms, conditions, de'inltions and exclusions speCified In thiS Agreement and subject to the paymtnt by Memb.r. of the .ppllclble Cop.yments, If Iny, Members shill he entItled to recelv, the Covered Service. listed below 3a""c.1 Will be covered by KHP Centrl' only If Ihay Ire Medically Necessary, and, except for emlilrgenCles, are proVided or authortzed by the Members Primary Care Physician or KHP Central OUTPATIENT SERVICES 1. ALLERGY TESTING AND TREATMENT Allergy I.sts and testing matertal$ and treatment, when authOrized by the Prtmary Care Pnysrclan 2 AMBULANCE SERVICES M.d!cally Necessary ambullnce services when ordered or authorized by the Primary Car. PhYSICian and KHP Central In an Emergency, the Primary Care PhYSICian's prtor authOrization is not required 3 ANESTHESIA Anesthesia Services when per'ormed In connection With Covered Servlce!l which hIve been authorized by the Primary Care PhYSICian and KHP Central 4 CHEMO-rHERAPY F.derllly approved chlmother.py drugs, the administration of thellt drugs and all !IIsacI.ted s '.... ......... ..'. I.boret_" 1.Ila/proc.dure. wh.n p,oYld.d or .ulhollZ.d by Ih. P"mllY CII. PhYIICl.n 'nd KHP C.nlre' 5 DIACNOIlTIC, LABORATORY .nd X.RAY IlERVICES M.dlcllIy N.c...lry x.rlY end labor'tory tilts, proceduros, IINIC'I Ind mlt.rllll. Including dllgnoatlc x.rIYI, f1uorolcopy, and ellctrocardlogreml when lulhorlzed or p.,formed by the Primary Clre PhYllclln and/or aulhorlzed by KHP C.nl,al 6 DIAL VSIS Medically Necesury dlillyal5 servlcea when luthoflz.d by the Primary Car, PhYSICian and approved by KHP C,ntr.1 and when provIded lit the Ho,pltal. a 'r..-,tandlng renel dialYSIS raclllty which he, been approved by KHP Cenlral or. With KHP Cenlral'a approval, In the hom., In the CilI' of ham. dlllysls. UltVIC.. Wilt mclude equipment. trllnlng. Ind medical supplies The r1'clslon to purchls. or rent nlSe.uary equipment for home dialYSIS Will bt mlde by KHP Central When Ihe Member becomes tliglble tor MedIcare coverage of dialySiS. coverage Will bit trenstlfred to Medicare coverage 7, HEARING SCREENING HeannQ ",..n,ng 'or d,aQno.I'lc purposes, when prOVided or authOrized by the Primary Care Physlclsn (See ArtIcle III. E)Ccluslons ) 8 HOME HEALTH CARE Ca'. proYlded by home h.a'th care personnel In the Member's home I' located Within the Service Are.. determined to b. MedlclUY Necenary, and au~ho(lzed by the Primary Care Phy"clan and KHP Centrul Such care II limIted to 100 "IS ItS per calendar year PTlvste duty nursmg WIll only be covered If speCifically approved In Idlllnce by the KHP C.ntral Mf'dlcal Director Horn~maker servlc.a or other non~medlc81 servlcea are not covered 9 HOME VISITS PhYIlr.18n vllltS to Ihe Member', home. Ir Within the Service Are., when performed or authoftZed by the Primary Clrt PhYSICian Members may be reqUired to p.y a Co payment 'or each home VISit Please refer to the Schedule of Copayments 10. HOSPICE CARE HOlplce care :servlcel\ for a terminally III Member With a IIf. expectancy of SIX (6) months or less when authoflzed by the Pnmary Care PhYSICIan Subject to . 81neflt MI)Clmum of $7.500 11 IMMUNIZATIONS Med'cally Neces..,y adu't Immunizations and pedlatrlr, ImmunIzations as prOVided tor below when prOVided ar authOrized by the Primary Care PhYSICian (8)Ccept those required for fCJrltlgn travel) Coverage Will be prOVided for those child Immunizations Including Ihe Immunizing agents. which as determined by the Department of Health. conform With standardS 0' the (AdvISOry Committee an Immunization Practices at thQ C.nter for Disuse Control) United States Department of H.lllh and Humlln ServtCII Coverage for these child 6 .., ".'..... .. ImmUniZation, Will not bl subject to Cup.y",.nl' or B.no'lt MUlmums 12 INDIVIDUAL CASE MANAGEMENT KHP Centrel m.y elect to arr8ng. for IIrvlCe'l under thiS Subscriber Agreement through prof.lllon.1 or faCIlity prOViders pursuant to an IndlVldu.llzed trellment plan Any ,uch arrangements shall b. made 1011ly at KHP Cenlrll's discretIon and only when Bnd for 10 long as It d.termlnes that Ihe 8110rn8tlv, "rvlces are Medlc.lly Necllllry .nd cost effective In no event shall KHP Central bl obllg.ted to prOVide such alternative servlCII It a totel COlt great.r thin for servlcefl to which the Member would Qtherwlll be entitled under thiS SublCrlblllr Agreement KHP C.,1I(lI'1 electIon to prOVide servlcel In slJch a manner Ihlll not obligate It to contlm.:e to prOVide the ume or IImlllr ,eNICIS 'or that or any other mlmber IllNDIVIIlUAllZATION OF BENEFITS Under c.rta,,' Clrcumstancel, KHP Central may be able to arrange alternative serviCes for Members by provldmg seNICl1 net speCifIed In thiS Agreement KHP Cenlral may prOVide luch alternative 18rvlCII at Its sole dll5cretlon. and (Jnly when and 'or 10 long as It determine' that the alternatlv, SONIC" are Medically NeclUaary and cost effecllve The provlllon of Bltornatlve UNIC.I In a speCifiC Situation ShIll not obllgete KHP Central 10 provuJe the same or similar lervlce. in another slluatlo~. nor ShIll It be construed as a Wllver 0' KHP Central's Tight to administer thiS SubSCriber AgrHment 10 accordance With Its express terms 14 'NFERTllITY In'.rt,llly coun.e'lng, IlIt,nQ and "",IC.., IOcludlng artifICial Inummatlon. but .)(cludlng !lJ i1t!.2 fertilization, sUbJer.t to a cClpayment 0' 50% 0' the COlt 0' treatmllnt, With a Benefit MaXimum of $2.500. inr.ludlng InJectables related to ,"fertility services 15 INJECTIONS ,nJeclab'. medlcat,on. '0' Ihe treatm.nt 0' .n Illness or Injury administered '" a phYSICIan's office as deemed appropTlate by tho PTlmary Care PhYSICIan 16 MAMMOGRAMS One ba.ellne mammoQ,am al or aner 35 years of age, one mammogram in ear:h cslendar year at 40 years 0' age and older. and additional mammogrlphy 5ervlces as authoTlzed by the Primary Csre PhYSICIan 17 MENTAL HEALTH CARE Outpatlenl manta' ha.llh ce,e, 85 determined by the PTlmary Care PhYSICian and KHP Centrol andlor Its deSignated agent to be nec.Slary and appropriate for short rerm eVAluation and/or CriSIS Intervention, for up to twenty (20) ViSItS per Member In . calend;ar year Each OutpatIent mental health VISit Will b. subject to a Copayment Please refer .0 the Schedule of Copayments 18 NEWBORN CARE Ca,a 01 . newborn child 0' a memb.r 'or a period 0' lhlrty.one 131) day. lOllow,nQ b,rth, I' medically 7 n.c....ry .nd .pproY.d by Ih. Prlm.ry Cor. Phy"cl.n Such care ,hill Include roulln' nu,..ry ClfI, prematuflt) uNle,.,' preventlv, health Clrt seNICes, 81 well U5 cov.,.g. tor InJurv or 11Ine.,. Including the neclnory cort: end treltm.nt C)r medically diagnosed congenlhll delecb end birth abnormalities ContinUing care II cover~d only If I) the newborn II !1.!.Sltl2.!! tor enrollment. b) thl newborn ~ IllL2!lIl1 w,lhln Ihlrty-on. 1311 d.y. 01 birth, and CI Ipproprllt. premium payments from th. date or birth or!?' recllved 19 NURSE MIDWIVES m. eONIC.O 01 . nu,," mldw,'. .r. covlred whln 8uthOrllld by the Primary Cafe PhYSIClsn ana KHP C.nlral 20 08STETRICAL CARE Ob.lelrlc., c.re Inc,udlng p'.- and pOlt-natal elrt, complications or pregnancy and childbirth Member' may be required to PlY a Co payment Plesse r.t., to the Schedule at Copaym.nts or copay rid.rs (See Artlcl. III, Exclullon. ) 21 OFFICE VISITS Offic. v,"I. p.rfo,m.d or .ul""rlzed by Ih. Primary Care Physician Menlbers may be required 10 pay I Coplyment for ,"ch office VISit PI.lse refer 10 the Schedul. of Copayments or copay rider. 22 ORAL SURGERY L1mil.d or.' ourg'c.' procedur.. In .n Outpallent setting when approved by a Primary Care Physician and KHP tttntral end required In connection Wllh tho lollowlng A Bccidental injUry to the JBW or structure, contiguous to Ih. J.w, inc,udlng .ccldent.lln)ury to Ih. t.oth, provid.d lnot cllr, or tr.atment IS sought Within twenty-rour (24) hours 01 the eccld,,"t causing such InJIJry; B the correction of a non.dentll phYSiological condition which IS resulted In severe runctlonallmpBlrment, and C, treatment for tumors Ind cysts requiring pathological examination or the Jaws, cheeks, lips, tongue, roor and tloor ollh. moulh (5.. Article III, Exclc"ono) 23. PREVENTIVE HEALTH SERVICES Preyenl,ve neallh SlNICII, including periodiC health ISsessm.nt., well child Clr., ilnd periodIc Papanicolaou (PAP) te,ts, according 10 sch.dul.. .pproyed by KHP C.nlr.', wh.n proYldod or I authorized by the Primary Care PhYSICian or when r .uthorlzed by KHP C.nlr.' 24 RADIATION THERAPY R.dl.llon Iher.py ..NIC.O, when provided or authorized by the Primary Care PhYSICian and KHP C.ntrol 25 REFERRALS R.lerrol. 10 P.rtlcIP.tIng ProYld." whe" luthorlzed by the Primary Care PhYSICian Rtferrals to non~p8rtlclp.tlng specialists and other duly licensed allied 8 health care perlonnel Will be :overed only when luthorlzed by Ih. Prlm.ry C.re PhYllcl.n I1.!llI KHP Cenlrol Self refer rails are excluded except In the CBSe or Emergencltl 26 SHORT-TERM REHABILITATION THERAPY SERVICES Occupational, phyftlcal, respiratory and speech rehabilitation therapy on an Outpattent basiS, when authOrized by the Primary Core PhYSICian and KHP Centrll The.. rehabilitation theropv Servlcel\ Ire limited to treatment for condlttons which. 10 the Judgment or the Primary Care PhYSICian and KHP Central, Will result In slgnUlcant Improvement Then theraplel5 are limited to eo days from Initiation of treatment per condition, per lifellme Short term rehabilitation therapy seNlcel mclude A Occupational Thor.py wll.n proYid.d by . Ilc.n..d prOVider actmg Within the scope of IlJCh hcenle, B Physlo.' Ther.py \Yhen proY,ded by . IIc.n..d proYlder acting wlthm th~ scope of such license, C R..plratory Thor.py wh.n provld.d by . IIc.n..d pro....lder acting Within the scope of such hcense, o Speech Therapy wh.n proYlded by . ',c.n..d proY'd.r acting Within the scope of such Ilcenll; (S.e Article III, E)(cluslons, ) 27 STERILIZATION - Oulp.llOnl y...ctoml.' .nd lub.1 ligations are covered If Medically Necllsery, 8S determined by the Medical Director 28 SUBSTANCE ABUSE. O'.goo", .nd m.dical Ir..lm.nl for the 8bu~~ of or addiction to alcohol or drugs when determmed to be Medically Necessary and rererred by the pmnary Car. Phy"cl.n .nd .pprov.d by KHP C.ntrel and/or Its dlllgnated 8Qe"t, to Include A Diagnostic ServiclI, Includtng psychiatric, psychological and medical laboratory test, B S.Nlce. proYlded by a olaff PhYllcl.n, P.ychologlol, Registered or Licensed Practical Nur.., and/or Certified AddictIons Counselor: C R.habllltallon Iherapy .nd coun..ling, o Family counseling Bnd Interventiol'; E Drugs, m.d,clne., .uppli.. .nd UII 01 .qu,pm.nl pro....ld.d by a Substance Abuse Treatment FICillty SeNlces for treatment of all forms of Substance Abuse Irt limited 10 sixty (60) oulp.tl.nl Full S...,on VlOlt., Equly,'ent PartIal Session Visits, or Partial Hospitalization Sessions per y..r, with . IIlelim. limit 0' on..hundred .nd tw.nty (120) Full 5",'on VII,I. E.ch EquIY.I.~1 P.rt,., S...'on VISIt will count as one-hair VISit 8galnlt the annUli maximum 9 01 .lldy (60) Oulp.llOnl Full S...,on VII,I. In .ddlllon. thirty (30) Oulp.ll.nl VIr,I. or P.rtlOl Ho.p,lallz.llon S...lona per cII,nda, Y'" may b. l.cl'llnged on a two-for.one bl.11 to IIcur. up to fltt..n (15) additional non~hollplt.l, rtlld.ntlal subst.nce .bulI tr.atment day" which ere In addition to the annuli and "'etlme mOXlmums d..crlb.d In Art,cl. II, INPATIENT SERV,CES Qulp.t,enl sub.t.nce abule treatment Vllltl may be subjlct to a Cop.ym.nt Pi.... re'er 10 th. Sch.dul. 01 Copaym.nl. (5.. Artlcl.llI, Exclullon,) 29. SURGERY Surgical "rYle.. required lor treatm.nl of dl..... or Injury wh.n .ulhorlzed by Ih. Prlm.ry C.,e Phy,'ci.n and KHP C.nlr.1 .nd p.rlorm.d by . KHP C.ntr.' P.rtlclp.ling Provld.r .nd .1 . KHP Canlr.' part,clp.ling I.clllly, Non.p.rtlclp.llng provld." or f.Cilll". m.y be .pproved by th. M.dlc.' O".clor .nd/or KHP Cenlr., ,r th, required .,rvlell ar. not 11/111.ble from participating providers or fleWti... 30, VISION SCREENING VI.lon .c".nlng 'or dl.gno'I,e purpo... wh.n proYidad by Ih. Prlm.ry C." Phy.,c,.n (S.. Artlcl.llI, Exclu.,on.,) INPATIENT SERVICES ANESTHESIA An..th..,. "rYic.. only wh.n p.rlormed '" connection with Cover.d S.rvice. which have been aulhorlzed by th. PrimOlY C.re Phy,'cl.n .nd KHP Cenlr.' 2 CHEMOTHERAPY F.der.lly .pproved ch.mother.py drug. .nd .11 ...ocl.led I.bor.lory I..I./procedu". when proYld.d or .uthorized by tho prlm.ry C.r. PhySiCian end KHP C.nlr.'. 3 DIAGNOSTIC, LABORATORY AND X.RAY SERVICES Medlc.lly N.c....ry x-r.y .nd I.bor.tory 1..1., proc.dur.., "rYlc.. .nd m.l.rl.,., Including dl.gno.t,c x-r.y.. nuoro.copy, .nd ,'.ctrocO/dlogram. wh.n .ulhorlz.d by Ihe Primary Car. rhy,'cian ,nd KHP C.ntrol 4 DIAlYSIS M.dlc.lly n.c....ry dl.,y.l. IOrYica. and .uppll.. wh." .uthorlzed by th. Prlm.ry C.ra PhYSlc,an .nd .pproved by KHP C.nt", Whon Ih. M.mber b.comas .lIglbl. for M.dlc.ro cover.g. of dl.'ysl., KHP C.ntra, dlIIY'11 coverage will b. transterred to MedICI" cov~rage ~ DRUGS AND MEDICATIONS Drug., m.dlcal,on., and inJ.ctions rec.iv.d end used IS In Inpatient In connectIon wllh Covered S.lYIc.. which h.ve b..n .ulhorlzed by the Prim.., C.ra Physicl.n. 6 HEARING SCREENING H..rlng Icra.nlng for dl.gnost,c purpOl1I when provided or luthoriz.d by the Primary Care Physlcl.n .nd KHP C.nlr.I, (S.. Artlcl. III, ExclUSion. ) 10 7 HOSPITAL Unllm,t.d ,np.tlOnt d.y. In . Ho.pU.' 'or Medically Nee....ry treatment when .uthorlzld by the Primary Clre PhYllclan Dr KHP Centre I. 'lCC.pt II noted herem for Inpatient mental healt" "NtCII Bnd ahort-term rehablhtalive Service, (Sue Inpatlflnt Servlc.s, Artlclft 11(21) IInd (24) 1 ElCC.pt 1M Emergencies, Hospital admissions must be coordln.ted through the Member's Prrmary C.re PhYlllclan When authOrized by the Primary Clre PhYSICian end KHP Centrll, covered Hospital Services rnclud. A Semi-private room and board (or prlvat. or specl.lty accommodations when certified .5 Medically Necessary by the attendmg phYltclan, the Pnmary Care PhYSICian and Kf-'P Cenlral) B General nursing care C Pnvate duty nurf,lng care when MedlcllIy Necessary and autnonzed by the Primary Care Physlclln and KHP Cenlr., o Drug" medications, and bl~IQgicall. E Me.'s (Includlrtg .p.cl.1 dlOt. wh." M.dlc.lly N.c....ry) F Use of the Qperatlng room and related faeillties, G Use of IntenSive car. or cardiac units Bnd related SeNlces H Oxygen SeNI':lIs. I Adm,n"tr.t,on of whol. b'ood .nd blood pl..m. 10 ",clude tho processing and preparation J M.dlc.lly N.c....ry .uppll.., .ppll.nc.. ."d .qulpm.nl (5.. Art,cl.III, ExclUSion.) . 8 IMMUNIZATIONS Medlc.lly N.c....ry .dull Immunizations and pediatriC immunizations as pro....id.d for below when prOVided or authOrized by the Primary Car. PhysiCian (except those required for foreign travel) Coverage will be provhJed for tnos8 child Immunlzltlons, Including the ImmunIzing agunts. which, as determined by the D.~.rtment of H..'th, conform wllh st.nd.rd. of the (Advisory Committe. on ImmUnization Practices of the C.nter for 0".... Conlrol) UrtIt.d Stal.. O.partm.nt 0' Health and HumIn SeNic.s Coverage for these child immunizations wlll not be subject to Co payments or Benefit MaXimums 9 IMPLANTABLE DEVICES Surglc.lly Impl.nl.d pro.lh.tlc devices wh.n determined to be Medrcally Necllllry by the Prlm.ry C." Phy.lcl.n and KHP Canlr.' (5.. Artlcl. III, ExclUSions. ) II 10 INDIVIDUAL CASE MANAGEMENT KHP e.nt,.1 m.y Illct fa .rreng. tor ..NICtl under this Subscflber Agreement through prof.Ulonel or facilIties providers (pursuent to In Indlvldulllzed !r..tmen! plan) Any auch Irrangem.nts shall be midi sollly at ~HP Central's dllcretlon and only whln end tor 10 long I' It determmes Ihlt thl allernltlve .lrvlcl. er. Medrc811y Necesssry and COlt effectlv, In no event 'hili KHP Centrll be obligated to provIde such IItern8tlvI '.""ICIS .t a total COl5t grelter than for IINICI. to which the Member would othel'Vv'lse be .nflUed under thll Subscriber Agreement KHP Central's fl.ctlon to provide "Nitti In suen 8 manner shalt nol obligate it to conttnue to provide the I8me or Similar urvle" tor tha,' or any other member 11 INDIVIDUALIZATION OF BENEFITS Un~er certain clrCUmstlnell, KHP Central mlY bll abt~ to erring. more IfflctlVI medlcll care tor Members by providing ser\llces not Ipeclned In this Agreement KHP Central may provide such Ilt.rnat,.... servlcls at It I sole discretion, and only wh.n Ind for so long I' it d.termlnes that the altern Clive servlCIS ar. MedlclIlIy N.c....ry Bnd cost eff.ctl.... The pro...illon of Itternltiv. S.rvlCes In II specific Situation shall not obhglte KHP Clntrl' to pro"'lde the I8me or Slmltar servlc.s In Inotl,., litulltion, nor shIll It be construed as a Wllver of KHP Centre", right to Jdmlnlster thiS SubSCriber Agreement In aecord.nc. With Its exprlll terms. 12 INPATIENT PHYSICIAN CARE G.n.rally .ccept.d and Medlo.lly N.c....ry h..lth IO"':CO$ p.rfo,med, pre.crlbed or IUPlrvislId by physicllnl within. hOlpltl1 for r'glstered b.d pltl.ntl, Inctuding dlegnostlc end ther.p.utlc care 13. MENTAL HEALTH CARE Inp.lltnl m.nt.1 h..llh car. s.rvlclS In e Pro'lIder f.cUlty whln authoriz.d by the Pnmlry Cere PhYSICian and KHP Cenlral andlor Its dtslgnlltd .g.nt, I,mlt.d to thirty (30) Inp.tltnt d.y. per M.mb..ln. col.nd.. y... (5.. Art1CI.1I1, Exc,uSlon.) 14 NEWBORN CARE e..e of. newborn ohlld of. member for . p.rlod of thirty-on. (31) d.y. 'ollowlng birth, 'f medlc.lly n.c....ry Ind Ipproved by thll Primary Clre PhYSICian Such clre ,hili Include routine nur..ry Clre, prematurity "rvlc", prevenltv. h..lth clre ,.rvic.., IS Will 85 coverage for Injury or IIIn..s, IncludIng the nec.llary care Ind tr.atment of medic Illy dl.gnotltd cO'1glMal defects and birth abnormlhtle. Continuing car. II cov~red only It .) the newborn I. l!llI!RlI for en,ollm.n!, b) tho nowborn !l I.!l.C9llIll within th'rty-on. (31) d.y. 0' b,rth, and cl Ipproprllt. pr.mlum paym.nts 'rom the date of birth Bre "CIIVed 1 ~ NURSE MIDWIVES Th. .."'".. 0' a nurse midwife are covered when authOrized by the Primary Care PhYSICIan and KHP e.ntrel 12 ...,. 16 OBSTETRICAL CARE Ob.tetrlco' cere 1"cludIMg prt- .nd pOlt.natal C8rt, complications of pregn.ncy and childbIrth (See Art,cle 1'1, Exc,'",on. I 17 ORAL SURGERY L'mlled or., .u'g,c.1 procedur.. wn.n appro...ed by the Prlmery Car" Physlclln and KHP Central and requited In connection With th. follOWing A aCCidental Injury to the Jawor structures contiguous to lhe J.w (exc,ud,ng I..thi. e the correction Q' a non-dental phYSiological condition which has resulted In a severe 'unctlon.llmps,rment, Ind C treatment for tumors and cysts requiring pathologlcsl examlnallon of the Jaws. Cheeks, I'ps. tongue, roof and noor of the mouth 18 ORGAN TRANSPLANT Med,c.liy N.c....ry transplantation SlNICII for member reclPI.nts wh.n not deemed to b. Expertm.ntal/lnv.lllgatlonal end authorrzed by the Prlm.ry e.rt PhYSlc,.n .nd KHP e.nlrel Determination of medical neceulIy shill alia tak. Into account the procedure's sUltabUlty for the pot.ntlll member and availability of approprtlte 'acihtles for performing such procedures KHP Central may arrange 'or c.rtlm trenlplent procedures In accordanc. with UI' Indlvidul' Clse Management prOVISIon of thiS Agreement SeNlces requltlld by a Member relat.d to organ donation wh.n the Member serves 8S the donor are not covered (5.. Article Ill, Excluslona) If not paid for by .ny oth.r .ourc., Ih. following ..",Ic.. of donors donating orglns to Member reclpllntl Ire cov.red A the removal ofthl org.n from the donor, B donor pr.p.r.tory p.thologlc .ndlor m.dlc.1 examinations, C donor post-surgIcal clre 19 RADIATION THERAPY Rodl.tlon th.repy ""'10" wh.n prOVided or 8uthorlzed b1' the Primlry Care Phyt1clln Ind KHP eenlrel. . 20 REFERRALS R.f.".I. to p.rtlc,p.tlng .p.clolllt. wh.n .uthoroztd by th. Prlmory C.re Phyllcl.n R.ferr.l. to non,p.rt,c'p.tlng .pecl.II.t. ."d other duly IIc.n.td .lIItd h..lth cert p.rsonn'l will b. COY.rod only wh.n .uthorlZtd by tn. Prlm.ry Cere PhYSlclln .nd KHP C.ntrel 21 SHORT-TERM REHABILITATION THERAPY SERVICES Occupellon." phYllc.l, rtsp".tory on~ Sp_h roh.blll!lllon thtr.py on an Inp.tltnt bill', wh.n .uthor,ztd by the Prlm.ry e.re Phy.lclln .n~ KHP C.ntr,'. T~... rehlbllltatlon therlpy '.rvlell Ire limited to tre.tment tor cond,tlcn. which, In Ih. judgm."t of the prlm.ry e.re IJ Phy,'cl.n .nd KHP C.ntr.I, will r..ult In IIgnll,c.nt Improy.m.nt Thll. th.r.PI.' .re Ilmilod to 60 d.V' Irom InltllUon of trlltment plr condition. per lifetime Short term rthlblhtltlon therapy lervlC'1 Include A OcCup.llon.1 Th.r.py whe" proYld.d by . licensed provider .cllng within the Icope of such Ilclnsl, B Phy.lc.1 Th.,.py wh.n proYld.d by . lic.n..d proYlder .ctlng within the Icope of such Itcenu. C R..plrolory Th.r.py when proYld.d by . "censed provider Ictlng within the scope of such Ilc.nse, o Spooch Th.ropy wh.n proYlded by . licensod proY'der tcllng within the scope of such license (See Article III Exclu.lon.) 22 SKillED NURSING FACiliTY SERVICES Sklllod NurSIng F.cIIllV S.",'c.. up 10 160 d.y. per Y.lr wh.n .uthorlzed by Ih. prlm.ry Cero Phy.,cl.n .nd KHP C.nlr.' Ch.rge. which relDte to non-cuatodiel clr. Ind Covered SeNlel1 which Ire MedtcIlIy N.CI.llry end not I)(cluded elsewhere In this Agr..mt"t (II' Artlcl. III, Exclusions) a,. CQvpred CUlled", or domlcWlry Clr, In I Skill.d NurSIng Facility or ellewher. II not covered Benetits are IImlt.d to semi- prlvlt. Iccommodltlons or In IIUOWlnCe equI' to the tlclllty'. mo.t frequ.nt ..llbll.h.d ch.rg. 'or seml,prly.,e Iccommodeti"ns which mlY be applied to the cost of prlvete iccommodltlons 23 STERiliZATION Inp.tl.nt y.secloml.S Ind lub.lllg.'lo", .r. cover.d only If Medically NecesSlry, 81 determined by the Medic,.1 Director, or If the procedure Is cOincident With hOlpltllizltlon for another relSon (Ie, post-partum tubal IIg.llon), 24 SUBSTANCE ABUSE Ol.gno.', .nd .hort-I.rm m.d,ca, treltm.nt tor the Ibu.. of, or Iddlctlon to, .Icohol or drugs includIng Detoxification, in In acute care Hospital or a Sub,'.nc. Abu.. Tr..tm.nl Flclllty 'or lh. .bu.. 01 or oddlctlon 10 .Icohol, whon d.torm",.d to b. M.d,cally Nee....ry ond .".ng.d through .pproprlll. "t.,,"1 by the Primary clre Physiclln, AI 8 .eparate benefit. non~medlcel, rehabilitatIve servlclS for substlnce abuse will b. covered In a Subslllnce Abu.. Treatment FICllity when determln.d 10 c. Modlcllly N.c....ry .nd .".ng.d through Ippropri.t. "",,"1 by tho Prlmory C.r. PhYSlcl.n Inp.tl.nt e.n.m. ",clud. A Oolo.llIc.t,on: e \.odglng Ind Ol.'ory S.rvlce., C DiOgno.,lc S.""".. Includ,ng p.ychl.trlc, p.yoholog,cl/ .nd modlc.ll.bor.lory t..I.: 14 . . . . ~.' ~,",. ....' r -' o S.Nlc.. proY,d.d bV . .t.tI Phy.ic,.n, PsychologlSl, R.glSter.d or l,,,nsed Prlctlc.' Nurse, .nd/or C.rt"lId Addlcl,on. Couns.'or, . E Rehablhtltlon therapy and counseling, F Family counseling and mterventlon, G Drugs, mediCines, supplies and use of equipment prOVided by the Substence Abuse Treatment Facility For all forms 0' Substance Abu.e, the detoxification ben.flt 1$ limited to no more than &even (7) days per admiSSion and four (4) admllllons per lifetime Similarly, the rehabilItative Servlen benefit IS limited to thirty (30) d'lYs per yellr In a Sub~tance Abuse Treatment FaCIlity, With a hfetlme limit of nln.ty (90) d.y. (S.. Anlc,. 'I'. Exc,uSlona) :25 SURGERY Surgical services re~ulred for treatment of disease or injury when authortzed by the Primary Ctlre PhVSlcl.n .nd KHP Cenlr., .nd p.rform.d by . KHP C.ntr.1 participating prOVIder and at 8 KHP Central participatIng facility Non-participating pro"lders or facilitllS mey b. .pproved by Ih. Medlc.1 Dlr.clor 26 VISION SCREENING VISion scre.nlng 'or dl.gno.tlc purposes when prOVided or authOrized by the Primary Care PhYSICian .nd KHP Cenlr., (Se. Article III, ExclUSIon.,) EMERGENCY SERVICES . Within the :S.rvlc. Ar... Medl.::al care IS available through KHP Central Primary Care Physlclsns 7 days a week. 24 hours a day Under almost all circumstances, the Member must obtain treatment or authortzatlon for treatm.nt from the Primary Care Physlclin or his designated covering phYSiCIan In the e".nt the member experlerces In Emergency condition, the member should contact theIr Primary Care Physiclsn If they cannot, the Member should seek medical care from the most readily available sourc' II 8 Member obtains cart In whyt th.y bell,,,. to b. an Emergency Without obtslnina authOrization from the Prtmary Care PhYSICian, the Member Will be requested to provide information about the occurrence KHP Central will then review the flcts of the sltultlon lInd the nllure of the services provided Only if KHP Central determlntl the UrvIC'S constitute 8n Emergency I' defined In thiS Agreement Will charg.. Incurred b. co"."d Each emergency room VISit shill be subject to . copeymln' Pl.... r.'.r to Ih. Schedul. 01 Coplym.nt. An Em.rg.ncy 10 .n .ccld.nl.1 Injury or Ih. .udd.n on..1 01 . condlllon which po..o . .Ignlllconl Joop.rdy 10 Ih. M.mbo,'o h..lth, requlrlnglmmodl.l. modlc.1 or ,u'glc.1 c.r.. H..rt .IIICk., .Irok.., pol.onlng., lOll of con.clou.n... or ".plretlon, and convul.tona .r. .umpl.. 01 modlc.' .m.rgonel.., I~ ! ;i i ~ f' 2 Oullld. Ih. SI",le. A.... Subj.elto Ihl Conllnulng C.,e prOyl.,on. III 'orth bilow, thl ch.'g.. 'or Med,e.lly N.CI..lry Covered SeNlc" whiCh .r. the relult or IIn Emerg.ncy occurring outSIde the Service Area are covered only It, In Ihe delermln.',on 0' KHP Cenlrll (1) the Member could nol hlye antlclplt.d the need for 'uen .eNle.. prior tu l.ilMng th, Servlc, Area, and (2) d".ylng c." unlll the Member could b. expecled to r.turn to the clre of the Primary Caf. PhYllclan might IIgnlficlnlly j.operdlz, the Memb.rs h..llh or life 3 Continuing elr.. Services of any PrOVider other tllan Ihf,J Pnme'Y Caf. Physician Will be covered only until the Member eln be traMf'fred, without medically harmful consequences. to the care or the Member's Primary Care Physlcl.n 0' . speclollsl deSlgn.ted by the Prlm.ry Car. Physlci.n ARTICLE III - EXCLUSIONS Th. rollowing ar. excluded from coverage under thiS Agreement S.rvlce, or supplill which af. (A) not provided by or .uthoriz.d by the Prlm.ry C.,. PhysiCIan; (6) not Medlc.lly N.c....ry, u d.termln.d by the Primary C." Phy,'cl.n .nd/o' KHP Centr.l, 'or th. dl.gnoSls or tr'ltment at illness, injury or restoration of phYSIological functlc.ns 2 The cost of services or supplies Whlc.:h are payable under Worker's Compensation or employer's liability lav..s or other legislation of SimIlar purpose. 3 Care for military service conn~ct8d disabilities and condItions for which the Member IS legally entitled to ..rvlces, IInd for which faCilities are r.aso"ably acceSSible te the M.mb.r 4 Clr. for co"dltlons thlt fed.rll, stlte or local law reqUIres to b.t".t.d ,n . pubhc t,cil"y 5 Th. COlt of servlc." covered under the Medicare Act when MedlClre IS primary In such situ It Ions, KHP Central or Its d'llgn.. Will file the Member's Medicare claims tor health IIrvtC" Medica,. will pay KHP Central or Its deSignee dlr.ctly Howev.r, If for any reason Medicare pays the Member directly, KHP Central or Its deSignee will bill the M.mber for the amount to which the Member 15 lIJntltled 16 ,." .,- .".., ,-" under M.dlcl" How.yer. thiS .xelullon .hlll not Ipply when th. group IS obllgllld by I.w to oHlr th. Subs.llber .11 the benefIts of thus contract anr1 the SubSCriber so elects thIS coversge 13S prtmary 6 The COlt of Hospital, rnedlcBI or other Covered SeNlc,s resulting from Bccldlnt.1 bodily InJurl" arising out or a motor vehICle aCCIdent, to the extent such ben.flts Ir. payable under any medical expense paym.nt proviSIon (by whatever terminology u!ild, Including such benefits mandoted by law) or any automobile Insurance poliCY unless otherwlls8 prohibited by applicable law 7 Dental cure, pertodontal care, Including but net limited to treatment of tho teeth, e""rnctlon of teeth, treetment of dental abscel5Ses or granuloma, tr.atment of glnglvll tiSSUes (other thin for tumors), dental ,xamlnatlons, and Bny other dentel product or servlc, unlell specifIcally prOVided el~ewh.re In thiS Agreement Anesthesia and facUlty charyes. related to ntIM-covered dental serv;ces shall not be covered B Any serviCes related to and rendered tn connection with I non.covered service shill not be covered 9 Treatment or temporomandibular Jotnt syndrome (only evaluation covered) If dental In nature or not Medically Necenary as determined by the Primary Care Physician .nd/or KHP Cenlr.l. 10 The cost of any l:.xperlmentalJlnvestlgatlve medlcll, surgIcal, or other hes:th car. servIces, proc.1dures or supplies, Including org.n transplant procedures deemed to be ExperlmentelllnvestlgatlV. will not ba covered. 11 Routine physical examination and pr.paratlon of specialized rllports solely ror Insurance, licenSIng, employm."t, or other non-preventive purposes, such as pre-marital examinations, phYSicals for collegllt, camp, sport or trsvel, which are not Medlc.lly N.e....ry , l 12 Cosmellc surgery. defined IS any plastic surgery don. prlt'narlly to Improve the appesrance of IIny portion of the bOdy, and from which no Improvement In phYSiologic functIon could be reasonably expected 13 All reh.billt.t,v. therapy exclpt .. due'ibld in this P,g"emenl, Including but nolllmlt.d to pl.y Ind "c""tlon"l ther.py 14 All routine viSIon and hearing .x.mlnltlons and I8Mc.. except i1B described In thIS Agr..ment 15 He.ring .,ds, .y.gl....., eonll:! I.n..., or the fitting thereor 16 Acupuncture 11 17 R.d,.1 kor.totomy '8 M.nt.1 h..lth/.ub.t.nce .buII ..rvlC., th.t .re not coyor.d Includ. biofeedback, chronic cer" court ord.red care, Including el" IS . ccmdltlon of plrol. Of prnbltlon. .ducatlonBI testing. .vllu.tlon tettlng. hypnosll, Interpreter ..rvlell, methadon. mltnt.nance ment.1 retardation "Nlctl, psychologlca' t.sttng and 8","I,on defiCit disorder and oth.r '..'ninO dlsabllltle' 19 Immunllltlons required for foreign travel 20 CUltodll1 end domiCIliary care, resid.ntllil cere, protective end supportive car. including educational seNICes, rest curti, convaleae'nt care 21 Weight redUction programs, including 811 diagnostic testing rel.t.~ to w.lght r.duct,on progr.m. 22, Perlonel or comfort items, Including but not limited to, admilllon kltl, slippers, television, telephone, air conditione's, humidlf".rs. barber or be.uty servleell. guest service end simile' incidental services and supplies which a.. not M.d,c.lly N.c....ry 23. Norm.1 d.llyori.. outSide th. S.rvic. Ar.. Within thirty (30) d.y. of lh. IXp.ct.~ d.I,y.ry d.t. 24 Any procedure or treatment deSIgned to slter phYSIcal ch.ractensttcs of the Member to those of the opposite sex. and Iny other trutm.nt or studl" related to 58X trlnaformationa. 25 Treltment of bunions (except cspsular or bone surgery), toe nllll, (except surgery for ingrown naUs), cornEl, calluses, f.U.n Irches, flat reet. woak teet. chronIC foot strain or symptomatic complaints Clf the (.et, unlell, deemed M.d,c.lly N.c....'lI by tho pnm.ry C.r. Physlc,.n and KHP C.ntr.I, 28, Contraceptive devic.., Including their Insertion a"d ,mplant.tlon, and birth control pIli, 27, In Yltro t.rtili..t,on, .mbryo tran.pl.nt. 28, R.versal of VOluntary sterilization 2ij S.rvlclI or ,uppll.. for which th.r. is no l.g.1 obllg.tlon on tho part of tho M.mb.r to p.y 30, Exc.pt II sp.clflc.lly proYld.d for In th,. A~r.sm.nt, prosthetic dtvicII, horn. medical equipment. durable m.d,c.' .qulpm.nt .nd .ppll.nc.., Including hu'th .ervlCIS Issociated with such dtvlCII 31 Prescribed drugs 8nd medIcations, except those whIch are .dmin,.tor.d to .n lnp.ti.nt or ... provld.d by . Sub,t.nc. Abu.. Tr,.'m.nt F.clllty 18 ..'....,.,...". . 32 Ambul.nc. ..rvIC.., un,... M.dlc.lly Noc....ry II d.torm,n.d by th. Pnm.ry e.r. PhYSlclIn .nd KHP C.ntrll 33 Whol. blood, blood pl..m. or blood compon.nt. 34 Servlce~ reqUired by I Member re'ated to organ donation where the M,mber IIrvea althe organ donor Expensll for donors donatIng organs 10 MlImbers ar. covered only I' deSCribed In thiS Agreement No payment Will bo mlde for human organs WhIch are sold rather tl18n donated 35 Court ordered servtCta when not Medically Necessary. II determined by the Primary Care PhYSICian and KHP Centr.1 36 Charges 'or completion of any Insurance form 37 Any Services. supplies or treatments not speci'lcally listed in thiS Agreement. except those reql.llred I)y the Pennsylvanll Department of Health as bllllC health services 38 Artifici.1 h..rt. 39, Surglcel oper8tlons or procedure, for correction of Obesity, ,nc,uding but not Ilm,t.d to g..trlc ".pllng or b.lloon procedures 40, Inferttllty injectables or other suppllls and drugs prelcnbed on an out-patient baSIS for or In connection wIth IIrtlficl.' Insemination 41 Grov..1h hormone,. unless determined to b. Medlc'lIy Necessary by KHP Central 42 S.rvic., for .I..p dl.ord... .nd .l..p thl/.py 43, Private duty nuraes, except IS specified tn thiS Agreement 44 Ch.rg.s tor f..'ur. to k..p . .ch.du,.d ,ppolntm.nt 45, Any se!"VIces related to InJUrlll Incurred whll. committing I r.'ony ARTICLE IV . GENERAL PROVISIONS ELIGIB,UTY AND ENROLLMENT A, The Sub.crlber, To b. .I'g'ble to b.. SUb,crlbl/, .n ,nd'Yldu.1 mU'1 re.ld. in . KHP C.ntr.' S.rvle. Ar.. .nd (1) li.. m.mbl/ of .n .lIglbl. Group who I. .ntitled to p.rt,c'p.t. In h,s Group'. h..lth b.n.nt. proprom, ,nc,udlng comph.n". with .ny prob.tlon.ry or w.,tlng p.nod .,t.bll.h.d by tho Group, .nd/or 19 (2) be entltl.d to coverage under B trust sgre.ment or .mployment contrsct. and/or (3) hovlng boon 0 Sublcnbtr, loove . Group and continue KHP Central coverage without Intenuptlon B, Eligible Dependentl, To be ehg'ble to be onrolled .. . M.mber, I D.p.ndent 0' . Subscriber mUlt meet .11 .lIglblllly requ,,"mentl ell.blllh.d by the Group, bo h.led on 8n EnrollmenUChange Form completed by Ihe Subscriber, and bit (1) The Sublcrlber'. leg.1 .pouse, or (2) an unmarried dependfilMt child (Including natural child, legolly odoplOd child, or .tepch"d) or IIlher Ihe Subscriber or the 5ublcrlb"r's spouse, who IS under Ihe age or 19 years or age Additionally, a dependent child shall Include I chIld for whom the Subscriber or Subscriber's spouse Is a court-appointed guardIan, or (3) an unmarried Dependenl child 19 yea" 0' age or older, who, In the JudglTlent or KHP Central, IS Incapable of selt81upport because of mental or phYSical handicap (for which continuing justification IS reqUired) and whose disability occurred prior to age 19, or (4) on unm.rrled Dependent child, between 19 .nd 23 years at ag.. who rosldes II"! the Service Area and IS a rull8time student enrolled in and attending an accredltel;1 educational institution. KHP Central may require approI', llle proot ot a Dependent's It.tUS before enrolling ..Id Dependent C;, Newborn children, Newborn children or a Member are covered under thll Agreement for the ',rst th'rty-one (31) dOYI Immediotely following birth Coveroge .n.. lhlrty-one (31) deys is contingent upon the newborn be,ng eligible for enrollment Ind the Subscriber enrolling the newborn child 018 Depondont wllhin Ihe thirty-one (31) day perl on and paying any applicable premium charges due. D, Enrollment. (1) Inltlll Enrollment. DUring Ihe '",l'a, Group Enrcllment Period, each .I'glb'o omployee shall b. entltlld to apply 'or coverog. for h,mself ann ellglb'e Dependents whO must be listed on the EnrollmenUChango Form prov'ded by KHP Central No proof 0' ,nsurob,nty ,hall b. req,,,ed (2) Newly Eligible Employ", Eoch new emp,oyee 0' tho Group entering employmont subsequent to lho Group's initial EffectIve Oate at Covltrage shall be permitted to appl! ror cov.rage ror hlmselt and eligible Doplndonts wlth,n thirty-one (31) days of bacomm9 20 eligible. subject to the enrollfTlent regulations In ,ffect With the'Group, Without proor at u1lur,blllty (3) Newly Eligible Dopendentl, Any person attaining eligibility to become 8 Dependent may be enrolled by the Subscrloer t1y con'lpletlng and submIttIng to KHP Central II Signed EnrollmenUChanglt Form Within thirty-one (31) days of Ihe Dependent's atta"'" .I~ eligibilIty No proof or Inl5urablllty shall be reqUIred (~) Group Open Enrollment. A Group Open Enrollmo~t Period shall be hreld 8t leasl, annually at which ftme eligible Subscribers andlol' eligible Dependents may enroll as Members under Ihls Agreement No proof or Insurablllt.y shalll'l. reqUIred (5~ Llmitlltlon. Persons Initially or newly eligible for enrollment who do not enroll wlthrn thlrty.one (31) days of becommg ellRible, or already-elIgible Dependents who do not onroll dUring a Group 'Jpen Enrollment Period may only be enrolled dUring a subsequent Group Open Enrollment Period Exceptions may be made only by wmten con!\ent or the Group and KHP Centrel E, Nollce 01 Ineligibility, It ,holl be the Subsc"bor'. or Group's responSIbility to notify KHP Central 01 any changes which Will affect the Sub,r.rlber's eligibility or that or Dependents ror ServIces c:lr Benefits under this Agreement Failure or the Subscriber or Group to notify KHP Central WIthin thIrty (30) days ot any such changes shall render SubSCriber Bnd Group liable tor any costs 0' Services or Benefits prOVided by KHP Central after the Subscriber or a Dependent became Ineligible to cOrltlnue coverage under thiS Agreement F, Rul.. 01 Eligibility, No person will be reru..d enrollment or re~enrollment by KHP Central becauSl! at health status. age /except as prOVided in ArtIcle IV, Section 18.). requirements tor health Services, or the eXistence, on the Effective Date or Covarage under thiS Agreement. or a pre-existIng phYSical or mental condition, Including pregnancy In addition, no Member's coverage shraJl be terminated by KHP Central due to health status or health care needs 2 EFFECTIVE DATE OF COVERAGE A, Subject to the paym.nt or applicable prom'um payments by the Group for the IndiVidual, KHP Centrel', receipt ot an EnrollmenUChange Form rrom or on behaU or each prospective Member Bnd the provillons of thIS Agreement (except as may be otherwise prOVided In the Group Contract), coverage under this Agre.em.nt shall hecome effective on the earliest or the followIng dates (1) When a person mllkes written Il:lphcation tor membership on or prior to the date he sati,fiea the 21 tllglblllty requlrementl of Article IV, Stctlon 1, cover.g. 'hili bl Ifflcllve .. of Ihe dill Ih. IlIg'b'hly requlr.ments are 'atllfled (2) When a person make, wnnen applicatIon lor memberlhlp Inlr the date he IItllfl15 the eligIbility requirements for Article IV. Section 1, cov.rag. Will be .NlCtlv, 81 of the flrat dAY of the calendar month follOWing the month In whIch the EnrollmenUChl)nge Form II ~ecelved by KHP Central, except a5 olherwlae provided by the Group Contract In addition, lIe!"/lcea IIhlll be provided startln!) at birth for nlM'born children of Members for thirty-one (31) day', and continue In effect there.ner if tho l1trWborn II ellglblo and enroHild by the Subl\cnber Within thllty-one (31) days of the newborn'l birth (3) Excopl "' olheM"o agreld 10 by Group and KHP Centrer, when a person makll wrlnen application for m.mborahlp dUring the Group Enrollment Penod, coverage will be on the first dey of the calendar month next follOWing the conclUSion of the Group Enrollment Period (4) Exclpl "' provided In Artlcll IV, Socl,on 7 hlrool. this Agreem.nt continues In 'orc8 for the period of one year from the Eff.ctlve Oal. of Coverage 81 shown on the recordl of KHP Central find from year to year thereafter unleu terminated as hereinafter specified, provided that KHP Central may change the promlum rat.s 8S heremafter provided. With the approval of the Commonwealtt' of Pennlyl'/ant. B, If, on the date on which coverage under thIS Agreement becomes eNectlve, the Member IS an Inpatient In a Hospital. benefits will be provided under thiS Agreement to the extent that they are not provided under a prior group Insurance Ig,""ment 3 MULTIPLE COVERAGE A, Work.,,' Compln,.tlon, Tho Benffits under thiS Agreement ror Members eligible ror Workers' Compensation ar. not deSigned to duplicate any 8eneflt to which such M.mberl are eligible under the Workerl' Compensallon Law All sums payable pursulnt to Workelrs' Compensation for Services prOVIded hereunder to Members ere payable to and retamed by KHP Centr'l It IS understood that coverage hereunder II not In lieu of, and shall not aNect, any requirements ror coverage under Workers' Compensatlon 8, Medlclre, Exclpl "' othl1WI.1 provldld by Ippl'cabl. fedlltr.llaw, the 8eneflts under thiS Agreement for Members age 65 and order, or Membltl otherwlSl elIgible for Mtdlc.r. payments, do net duplicate any Benefit to which such Members are eligible under the MediC.'" Act. Including P.rt B of luch Act. Where Medica" II the responSIble 22 I'" .. plyor, III '~m' pIYlble pursulnt 10 Ihl MedIC"" progrlm 'or ServlC'1 provld.d hereunder to M.mbers I,. payabll 10 Ind rl'",nld by KHP Clnlrll C, Mlmbe,,' Cooperltlon, Elch Mlmblr 'hili com pilI. oM submit to KHP Cenlral such conslntl, "I'.UI, a59lgnments and other docurnentl II m.y be reqUired by KHP Central 1M order to obtlln or Inur. reimbursement undtlr Medlcar, Dr Workers' Compen5l110n Any Member who fBlll to 10 cooperate (IncludIng a Member who falls to enroll under Part B Dr Ine MedlCI.,e prcgram where Medica" III the responSible plyor) WIll b. responSible to KHP Central ror thl! Relmburument Value of Servn:es subJf.lct to thll Sletlon 3, and may be terrntnaled In accordsnce WIth Article IV, Socllon 7, E 4 LlM,TATIONS In the Bven that, due to circumstances not Within the control of KHP Central, Inchldlng but not lImIted to a malar diluter, epidemIC, the complete or partlal destruction of facllltle., flat, CIVil Insurrection, or Similar caules, the rendition of Services prOVided under thiS Agreement II d.layed or rendered Impractical, KHP Central ,hall make 8 good faith effort to arrange for an alternative methud of prOViding coverage In such event, KHP Centrel shall prOVided Covered ServlclI covered under thiS Agreement Inlofar 85 practical. and according to ItS belt Judgment, but neither KHP Central nor PrOViders shall Incur liability or obligation for dolay, or failure to prOVIde or arrange for ServICes If such failure or delay IS caused by such event(l) Except In Emerger.cles, the Pflmary Cere t'hysiclan musl coordinate and approve ServiCes to be coverod 5 RELAT,ONSHIP OF PAR1 05 KHP Cenlral Pflmary CarB PhYSICians maintaIn the phYSICian-patient relationshIp With Members and are solely ruponslble to Members fer aU medIcal Services The relationship between KHP Central and KHP Central pnmary Car. Physlclam., and between KHP Central and other contracting Providers of health Services, IS an Independent contract relationship KHP Cenlral Primary Care PhYSICians are not agents 01' employees of KHP Central, nor 15 any employee of KHP Central an employee or aQent of KHP Central Ptlmsry Care PhYSICians KHP Central shall not be liable for any cl81m Qr demand on account or damage' arising out a', or In any manner connected With, any InJunls suffered by the Member wh'le receiving care tram any KHP Central Ptlmary Care PhysIClln or from any PrOVIder to whlr.h tM Member has baen referred by the Ptlmary Care PhYSICian or KHP Central 23 e PAYMENT OF BENEFITS A. Id.nllne.llon C.rd. For pur po... of Identlficetlon end specific cov8reg8 Information, B Member's Identification cerd must be presented when 8 service is requested B. Allport. .nd Record., The Member con.ent. to .nd luthorlZ" .ny person or orglnlzatlon which proYldes Covered Services to Member to furnIsh to KHP Centrel and to other prOViders of Covflred Servlc.s, Information or record I pertaining to the Member, Including but not limited to records Bnd informetlon regarding the Member', phYSical or mentel condition. history, or treatment Further, the Member consents to and authorizes KHP Central to furnish such Information or records concerning the Member to such providers of Cov.red Services and to other IndIVIduals or organizations for peer review or utthzatlon review purposes, Ind 81 otherwllse required by law Finally, the Membar agre.. that approy.1 by KHP Centr.1 ot p.yment. 'or .ny Cov.red SeNices, facilities, or suppllel il contingent on KHP Centrll', receipt of such information or records as It mey request. C, M.mber LI.blllly. Except when certein Cop.yment or other IImltationl .re specified in this Agreement, th18 Member il not lieblB for any 1;harges for Covered Services when Covered Service, have been authOrized by the M.mba~. Primary C.re Phy.,ci.n or the KHP Centr., M.dical D"'Clor. O. O.I.rmln.llon of Modle.1 Nec'lIlly, Tha SerVll:e" f.clllll.. or .upplla. da.crlbed In Artlcla II 0' thl. Agreemenl are covered only when they are Medically Necessary for the ra.toration 0' the Melnbe~. he.lth, .. determined by the Prim.ry Cara Phy.,cian or KHP Centr.l. Any Service. requested by a Member which are not Medically Necessary will not b. covered. E. AIIlgnm.nl, Any rlghl. 0' . Member 10 recelye Covered Services or payments under this Agreement are personal to the Member and may not be assignod to any person, Proylder or ent,ty, wilhout written conaent 0' KHP C.nlr.' F, Coordln.llon of Ben.flla Wllh Olher H..llh Cor. PI.n.. II th. Member I. .1.0 enlltl.d to receive Benefit, under any other Group health care plln for ..rvices covered by thiS Agreement or under any governmental program for which any parlodlc premium payment I. m.de by or for the M.mber, payment. m.y be coordin.ted b.twaan KHP C.ntral and tha other health c.re pl.n In.iI c...., KHP Centrel will p.y benefit. fir.t .nd determine lI.bllity I.'er II It I. datermined th.t KHP Centtll I. th. ..cond.ry p,.n, KHP Central h.. the rlghl to recover the .xpen.. alre.dy paid In exca.. of it. ".bllity a. th. ..condary plan The Member wHI be reqUIred to furnish information Bnd to take such other action as IS nec.ssary to assure the rights of 24 KHP Centre I In datermlnlng whathar KHP Centlll or .nother Group health plan h.. primary Ii.b'lity, the 'allOWing will .pply (1) It the other plan does not Include a coordination of benefits or non~dupltcatlon prOVISion, thlt plln will be the primary plan (2) It the other plan does Inclllde iJ coordination of benefits or non-duplication prOVISion (a) The plan covering the patltnt other than 85 a Dependent Will belhe prlm.ry p,.n (b) Where both pl.n. Coyar Ihe p.'lOnt .. . Dependent child. the plan covering the patl,nt as B Dependent child of a parent whose date or bIrth, excluding the year 0' birth, occurs earlier In iii cBlend8r year, shall be tile primary plan, If both parents have the same blrthdflY, the pial' which covered the parent longer Will be the primary plln. If the other plan does not include this provIsion. the p~ovlslonl of that plan will determine the order of benefits (c) If the p.rent. .re .ep.r.ted or dlyorced. the follow,ng will .pply (i) The plan which cover! the Member as a Dependent of the p.rent with cu.'ody w,lI be the prlm.ry pl.n The .,epp.ren, w,lI h.ye .econd.ry responSIbility and the parent Without custOdy will have tinal responsibility (II) Whare lhera i. . court decrae which e.t.bll.h.. fin.nc,a' re.pon.,bllily for th. he.lth c.re .xp.n... of the D.pendent ohlld, the plan which covers the child as 8 Dependent of the parent with such financIal responslbUft'y will be the prlm.ry pl.n, (Iii) The Benem. of e pl.n coyerlng tha p.tlant as a laid~otf or retired employee or IS the Depend.nt of . '.Id-ort or retired employ.e .h.1I be determined aft:.r the Benefits of any other plan covering such person as an employee Ihlll be determined aft.r the Senefits of any other plln covering such perlon as an eITlploy.. or D.pend.nt of .uch person If th. other plan do.. not have the rule regarding lald~otf or retired .mploy.... and If, a. . re.ult, th. pl.n. do not .grfll on the order 0' b.nem., the rulo will b. ignored (iY) Whera tha determinatiOn cannot b. m.d. In .ccordanca with th. proc.dlng p.ragroph.. tho plan which h.. covered th. pelient for th. long.r period ot 11m. will beth. primary pl.n, 25 (Y) Servlc.. proYlded undor .ny goy.rnm.nlal program tor whleh any pe"odlc premium peyment 15 mad. by or lor lhe SubsCriber 'hall alway. b. the primary ptan, e)Ccept where prohlblt.d by lew (3) Service. under thiS Agreement for thl!t treatment of Ir.jury 6Irlllng out or the matntt"e"ce or use or II motor vehicle shall be covered only to the extent that 5uch ean.flts are In IXCes, of. and not In duplication of Servlc.s p.ld or payaole (I)under 8 plln or poltey 01 motor vehH;le Insurance, provldfld that non-duplication IS contained herein IS not prohlblled by 'ew or (b)lhrough Ihe C.lulrophlc Los. Trusl Fund, or (c) through a pro~r.m or oth.r err.ngemenl 01 quall,..d or certified self-Insuranc. KHP Centrel may release to or obtain from any person or organizltion any informetlon about coverage, ')(13'"1" and Benefits which may be neeenary 10 coordinate Senefits. For the purpose of coordination of 8lnetltl, If the Member reCllVIS IIrvIC.S, faCilities or suppll.. .Ylllablll und.r IhlS Agrl.meot but not proYlded by nor lulhorlzld by Ih. Membl~s Prlmlry Care Phys,clen, paymenl w,lI not b. mlde by KHP Central Thle proYlsion do.. not Ipply 10. In IndlYldual he.llh car. plan issued to or in the name ot the M.mber; group or group-type hospllll Indemnity benems of $100 per day or less; cr school Iccident-type coverage, 0, Sub,,,,,ellon. (1) If Iny Coy.r.d Service Is provided to the Membor under this Agr..ment, KHP Centr.' sh.,1 be subrogaled and succeed to the Member's rights or recovery wllh resp.ct to the Covered Servlc., or supplies Involved Iglll1lSt B responslbl. third party and/or Insurance complny, (2) Subrogetlon me.ns thlt If Ihl Subscrlb.r or lhe Subscrib.~s Deplnd.nt(s) is injured beclu.. of the nlgllgenc. or wrong doing of aoolher plrry, KHP Centr., hi' the right to Silk recovery ot the R.rmbur:1ement Vllu. or rellted Covered Services prOVided The M.mb.r Is expected to cooperate With KHP Central and t.ake any sction nec.ss3ry to protect Bnd to assure lhe subroglllon rights 0' KHP Cenlrel (3) This provision do.. not Ipply to In mdlYidua, insurance policy covering a Member Th.re will be no right of subrogltlon where prohibited by 'ew 26 ". ".,,,., KHP Central may, Without con"nt of or notice to any person, release to or obtain from Bny Insurance complny or other organization or person any Information, With respect to any person, which KHP Cerltrsl deems to be necessary for Ihe purPOIiI of determining lis liabIlity under thiS Agreement Any person claiming Benefits under thl5 Agreement agrees to furnish KHP Central such Informatton II may be necessary to !mplement thll prOVISion KHP Central has the right. at any time, to ,equlre such mformiltlon to be furniShed 10 It wllhout cost or e>cpense III a conditIon precedent to liability for any claim for Covered Services under the terms IJf thlb' prOVISion H. Wllver of Lllblllly, KHP Car,tra, shall not be habl. lor InJunes ~esulttng form negllgenc., misfeasance, nonfeasance or malpractice on the part 0' any PrOVider In Ihe course of performing Cov~red Services for Members I. Legal Action. No legal actIon may be commenced against KHP Central with respftct to the Agreement until ninety (90) days atter KHP Central hss rec.ived 8 properly completed claim form or Encounter Form, nor may such action be tsken at all later than two years efter the Covered Servicea or supplies were performed or prOVided J. Grlevanc. Procedur.. Informal R'.olutlon Procedure Members haVing concerns, problems or complaints mvolvlng Benefits under Ihls Agreement, the availability or dellv.ry of Covered Servlc,s, Ihe Member's Primal)! Care PhYSICian or other prOVIders; Ihe operation of KHP Central. or the terms of thiS Agr~ement should contact KHP Central's Member Serv!c81 Department Staff members will work With the Member to attempt to resolve concerns or disputes Informally In communicating with the Member Services Dllpartme"t, the MerT'!ber Should prOVIde pertinent Information regarding th,ir concerns InqUIries may be directed to the Member ServIces Department at the following address, or by callrng lhe Department .t 1-800-622-2843 Member Services Department Keyslone H.a'th Pl.n C.ntr.' Post Office Box 898812 Camp HIli, P.nnsylyanll 17089-8812 If a Member II not satisfied With KHP C.ntral'!I response concerning their complaint, the Member may file . formal grievance There are mo steps in the Keystonl Health Plan Central grievance process Form.' Grievance Procedure The grllvlnce wlll flr.t b. r"","wed and Inv..t'gal.d by the l!!lIlI!-.Qd~ ~mmittu:, composed 0' two or more managem.nt staff. The member Should forward pertinent written information regBrdlng the grievance to the committee The commIttee 27 WIll p.ovlde . written deCISion wltl'lIn thirty (30) daya or Its r,cllpt of a grievance The Inlhll Grl.vance Committee's O"Clllon will bu binding, unle" It'le Member appeals tt'l, decIsion The appeal of the Inlllal Grl8\1snCe Commlttee'a deCISion It'llll be to the Grievance Review BoarJJ The Guevance Review Baird IS estllbllshed by Ihe Board of Dlrflctors Bnd Includes It le..t one-third Subscribers to the HMO The GrI.venc. RtvllW Board will hold an mformal he8r1ng In which the Member (and any other Inlerested party) may prl..nt, In person or In Writing, Ihelr pOSItions on the disputed matt.r The Member hos the right. but 1\ not reqUIred, to attend the hesrlng, Such a hearing WIll be held It a time which IS mutually acceptable to the Member. Ihe Board end any other persons In'v'olved KHP Central Wilt prOVIde the Member wilh written Information on Ihe hearing procedurea KHP Centn'l Will hold the hl8r1ng wllhln thirty (30) doys ", receipt 0' the Member. reque.t At eny stage or the grievance proces', the Member has the right to requllt that KHP Central appoint a Itaff member who has no direct Involvement to assIst the Member Th. Grievance Review BaIrd Will Issue 8 fornlal 08CISlon 'v'llhln ten (10) days of the h.anng The Board's deCISion II binding unl'" the Member apPells thu deCISion to the Bureau of Health FinanCing and Program Development, IOClted In the Pennsylvonlll Departm.nt fJ' Health, Room 1025 Heelth end Welfare BUlld,ng, Po.t Office Bo. 90, Herri.burg, Pennsy,van,a 17108,0090,(717) 787-5193 Grievances usually deal with claim denials end the remedy .ought " peyment 0' the c,,'m by KHP Centr.1 However, In thosl CISII In which . Member believes Ihlt UrlOU, mldlcll consequences Will arise from KHP Central's failure to prOVide the requested ".alth Slf\lICeI, the mllmber may request an excedlted review To do ao. the Member should contact Ihe Member ServIces Deportment, IdentifYing Ihe particular nlld tor In expedIted review An expedited review may be conSidered Urgent Review Case IS r,vlewed by the medical dlrectQr and a deCISion IS rendered In writing to tn. Memblr within fine.n (15) day., Emltrgency Review' C..e IS re\llewed by the medical director and 8 decl!Slon IS rendered In writing 10 the Member within two (2) working days, With ,nitl., notlf,cetlon by telephone, when appropriate If the medicet director', deCISIon IS adverse to t~e Member, the M.n'lbtr may appeal the deCISion Immediately to the Medlcll R,vlew Commlttl' by contacting the Member Services dip art mint Thl medical dlfector Will contact thl Medical Review Commltt.. to present the Member'1 case This commltt.t, 2M compo led 0' It least two phYSICians. Will 'IvUIW the call and render un Immedl8hl deCISion The Member Will bt mformed VIEl letter ond by telepho,e. when appropriate The Member Will be Informed or the fight to appelll the deCISion to the Pennsylvania Dlfpanmenl or "i.alth 7 SUBSCR'8ER AGREEMENT A. Entire Contract. The enllr, contract betweon KHP Cenlrol and the Member conslst$ or Ihe Group Contrlct, the Enrollment Form, thIS Agreement, any amendments to It, and the appropriate premium rate B. Premium RI". The Group, or In the case of Indlvldull or group converSion contracl$, the SubSCriber. sareeslo pay KHP Contral In advllnce, on a monthlv basIS, unless othef'INl5e agreed. the applicable premium rat, 81 filed with Bnd approved by Ihe Commonwealth of Pennsylvania C, Ch.ng.. of Premium R.t., KHP Centrel, .ub,ect to the approval of the Comm~nwearth of Pennsylvanll, may change the premium retes In th, event of luch change, the Group shall be notified In advance of Ihe effectIve dll. of change Any notice will be considered given when delivered to the Group 0, Termln.llon of Group (1) Subject to ennuo' renewe' by the Group end KHP Central, this Agreement, IS amended from time to time, Will remain In effect from year to year unless terminated either by the Group or KHP Central (2) The Group or KHP Central mey termlnete thl. Agr.ement u~on thirty (30) d.ys wrihen notice 01 termInation given to the other plrty (3) This Agreement .hell autom.tlcelly termln.te ., KHP Central'. .ole di.cretlon " KHP C.ntrel doe. not rece've the periodiC premium peyment w,th,n thirty (30) dey. 'ollowing the due d.t. (4) In lhe ..ent 01 termlnetion 0' the Group, eovereg. 'or Members 0' thet Group will end es 0' the lul d.y 01 the period for which the lesl premium peyment hll baan recelvld (5) Members 0' a discontinued Group m.y b.com. converSion Members provldld the Group do.. not participate In or secure co".rlgl under I he.lth benefit plan made eV'llable by lome other orglnlzltlon and the termination Is not done with th, antiCIpation of ..curing health benefit coverage With another org.nlzltlon E, T.rmln.tlon 01 Sub.erl..... .nd M.m...... In uddltlon to terminating coverage under thIs Agreement for the Group es e who,e, KHP Central mey termln.t. this 29 Agr..m.nt I' to .n IndIvidual Sublcrlb.r or Member 0& 'ollowI (1) upon thirty (30) day' written nollee of termination for cau" (Iueh I' fraudul.nt UII of 8n Identification clrd) by KHP C.ntrll However. l<HP Central Will nol termln.te thll Agreem.nt beclull of 8 Member'1 Medlcallv Nlelnlry ullllzatlon of Services covered under thiS Agreement. (2) If the Subactlblr In obtaIning coverage hereunder .hall hrve 8cted fraudulently or n\lareprllented or tailed to disclose a mat'rlBI fact In such case, KHP Central mey, II Its option, terminate thll Agreemenl In Iccorr1anCI with paragraph (1) above The Group or SubSCriber will forfeit any charges paid to the extent of the liability Incurred by KHP Centrll. (3) 11 the Member IS unable to maintain a ISt1l5factory physicien-patlent relationship (See Artlcl. IV, SectIon 7, J), (4) If the Group or SubSCriber fralls to cC'operate on CClordlnatlon of benefits or subrogation ISSUes. (5) for misuse of the Mamber identification card F, Obllgatlona on T.rmlnatlon, In th. .v.nl 0' termlnatron by the Group or by KHP Central (1) KHP Central .hall not b. hOb,e for any """c.. Incurred by any Member In the name of KHP Central beyond the petlod for which the premium rate snail halle bOln paid, and KHP Cenlral .hall b. entitled to Indemnification by eIther t". Group or the Subecrlber for Bny e>cptnse paid by KHP Central under such circumstances (2) When thIS Agreement IS terminated. ,>ccept for termln,tlCn by Incorrect !nformatlon or mIsrepresentation, and. Member IS receiving Inpatient Services bIlled by a Hospital on the date of termination, benefils WIll continue to t)e prOVided only to the date of dlScharg. or ft>cplflillon of eligible benefit days. whlchev.r IS earher O. R.ln.tatem..nt. Any IndllJ1dual Member whose m.mbershlp shall have been termlnat.d may be reinstated It the dIscretion of KHP Central, and upon paYl":1ent of any retroactive premium payments and penalty due H, Other Chang.. In St.tu.. Appllcet'on. tor change. " conrract type or addItion, or deletions of eligible Dependents shill b. filed on Subscriber Ofltl Change Forms supplied by KHP C.ntral and shall become ,ff.ctlv, Ind a part of thiS Agreement upon acceplenc. by KHP Centr.1 10 I, ~"on.ou. P.ym.nt., If KHP C.nlral Ihall pay 'or any excluded ServlclI or luppllll through I"'dllettence or .rror. the Group or Member Ihlll relmbufl. KHP Cenlrsl for such payment. J. COnver.lon. ( 1 ) The Sublcrlb.r who becom', Ineilglbl. for cOllerage under tnll Agreement bftcause of termination of emplo!'ment under hi' Group and who II not eligible to become enrolled under any other group h.mlth benefit p,an may apply w"hln thirty (30) day I an.r luch terminatIon 0' omployment to continue coverage under an Agreement 0' the type tor which he IS then elIgIble F or Members currently enrolled under a family contract, thiS conversion priVilege IS also available to the surviVIng Dependents In the event of the Sllbscrlber's dealt" to a spouse when divorced from the SubSCriber, and to a child who centis to be an eligIble Dependent due to attaining the maximum age of eligibility ThiS conversion Dflvllegd 15 not available to Member~ who have bun terminated for cause by KHP Central (See Article IV. Section 7, E l. cr for Members who have 'ailed to apply tor conver.ion Within tho lI"rty (30) day period The terms of conversIon coverage may be dIfferent than the terms herein (2) It lhe Momber be com.. eilglble lor Medicar. Part A or Part U, tho Member shall have tt.,e right at that time to convert to such programs as may tnen be available 10 prOVide coverage In conjunctIon With governmental programs (3) It a Member enrolled ,n KHP Centra, through a Group voluntarily elects to terminate hl~ coverage With KHP Central while remaining eligIble ror Group coverage, the Member shall not be eligIble for conversIon to such non-Group programs as KHP Central may have available K, Continual Ion of CO'I.,.g., Federal law {"COBRA") requires that under certain ctrcum~tanc8S the Group offer to the SubSCriber andlor Dependents of tne Subscriber ("Qualified BenefICiaries") the option of conflnl.,lIng coverage under the Group's contract With KHP Central when such coverage would othel"NlS8 terminate The circumstances under which thiS option IS 10 be e>ctended 10 the Qualified Sene'lclsrles Include (.II termination of the SubSCriber's employment. either voluntarily or 1n1J0luntarlly. (b) the death of the SubSCriber. (cl divorce or legal separation or the SUbGcrlber, (d) D.pendent children reaching otherwise applicable age limits und.r thll Agreement, and (.) SubSCriber becoming eligible 'Or M.d:elre benefits SUCh QuallfleQ 8eneflclarl.' milY able In the S8me cover.g. as the Subscnber IS entitled to, for 8 period of three Y.",I follOWing the event In queltlon In the case of termination of employment. tho applicable Pltlod is elght.en months Th. 11 , , 00 Keystone Health Plan"' Central ", , ~" An IndltpeMenl LlceMee ollM Bill" Cro!l!l aM BIlJ9 S/'llelfl .A!\!I0Clatlon i Keystone Health Plan Central, Inc. P.O. Box 898812 Camp Hili, PA 17089-8812 17'17) 783-3894 or (800) 822-2843 Keyllone IIIIIIh PIIn~' Centrel (~'~~~::X"IM)n KOVllono H..llh Plln Control, Inc. P,O, Bo.898812. elmp HIli, PA 17089.8612 r I GEARy,JA~~~,L 15'18F HIGrl ?CL~TE OR HARRISBUqG.?A 17025 DATE CLAIM NUMBER PATIENT NAME PROV'DER NAME PAID TO CHECK NUMBER If you hlvO quoaUona Iboul Ihla hpllnlllon of Bonofila cIII (7171 763.3894 If oul of tho Hlrri;ourg' aroo. cIII HIOCHI22.2&43, 03/13/Q5 425dC'4.::1 7J'~ GiOARY,H'1i:5,L OCCU~ATIO~A" ~~rlA8 & RESEA~CH GEA"y,JA'-1,:~,I. NO CHeCI< L .J AGREEMENT NUMBER 1 S : .. ~ 14 6 9 GROUP NUMBER 1 3 I; 9 3 0 EXPLANATION OF BENEFITS SERVICE OESCRln,ON AMOUNT BillED AMOUNT AllOWED LESS INELIGIBLE AMOUNT AMOUNT PAID __~N CO'IS, . 0: J;i:;4 PHYSICAL 'l~OICINE TR 2",,? .,:J 0.00 1').0,.J ,.).00 ....1...9 C'.;: ';=~394 ~HYS I CAL "'::JICI;~E TR -:07. ;J O.(lO :1. '~I,J 0.00 Wl"'9 03 ;: c::.: S,,4 PHYSICAL ,'l';JEI'~E TR 2C 7. ~,.J O.'1C '1.0.J ';.0'1 ....149 C,+ .)~~,., ,4 PHYSICA~ '1'01 C !.'~E TR "'1. ) 'J 0.00 '1.':I.J 0.00 '~149 0, ~ ~ ~ : 94 ~HYSICAL M,JICINE TR 2 v 7. I') ~ 0.00 'J.:1 .j (l.00 W149 Cc; ';',394 PHYS ICAl M'o:JTC INE TR 49.~J 0.01) O.JO '~.OO \0/149 C7 .iS2S94 ~HYSICAL ,'Ir.OTC I;~E TR 207.% O.CO ,~. 'J J '.).(lO \0/14':1 'J<3 J 'i';: . 94 ~HYSICAl /4" ')I: I NE TR 49.'J(l 0.00 ,J .1,j 0.00 \o/l49 ... T J r .. - S .*. l.:.z.:.;J (l.OO O~:.:;. .J.(l0 K':ASON CO~.SI ~l49 SERVICE ~~s ~OT AUTHORIZED BY THE PRIMA~Y CARE PHYSICIAN. You afe not responsible for any dltferflnce between me amount billed and' Ihe amount paid tor an'} eOI/ered Services. unless an amount is speCllledlnltle "LESS INELIGIBLE AMOUN'T" ,::OhJmn Please reler to Ihe e.llplBnl1110n above tor any Ineligible amounls, If your claIm has been denied In wh()lo Qr In pari, you have Ihe rlqht 10 rsqUF,lst 11 revIew To appeal l) claim IlIe a WAlnlN A'PIAL WITHIN 10 DAY' ..'T." RlellVING THI. EXPLANATION 0' RINE"TS STATIMENT. Please refer 10 the "Grlevance Procedure" ,ection 0' your Member Agroemenr for I1ddlllonRlmlormnllon rhf} Appoal f,hoIJld be !ent 10 Keystone Health Plnn Cenual, Inc:, Member Hervices Cept. 80.ll898812. Camp Hili. fiJA 1708l}..8812. ..,01> ";.',., KeyItone II..... PIan,~/ Central .""'~l,.~...oIlh. l~ IIuI'CfY)II'Ind'" ShIIold "11OO1Inu.1 r GEARy,JA~Af:S,L :SOdF Hlr.rl pn:~TE OR HARRISeUoG,PA 17025 .., DATE CLAIM NUMBER PATIENT NAM~ PROVIDER NAME PAlO TO CHECK NUMBER If VOU hlvl qUllllonl Ibout thl' bpllnltlon 01 Blnlflt. 0111 (717) 7&3-3&84. II ;;;: of tho o 3/1 3/9 5 Harrl'bur~ "", c'1I1-MO~22-21lo13. 425804620C" GEARY,JAMES,L OCCUPATIONAL REHAB & ReseARC~ GEARY, JAMES, L NO CHECK , K.Vllon. HIIUh Pl,n Conlrol, Inc. PO. Bo. B98BI2, C.mp HIli. PA 17009-0012 L .J 1~;:4614t'l AGREEMENT NUMBER 1 36':' 3 0 GROUP NUMOER eXPLANATION OF BENEFITS F"""" ~ERVICE DAIf..L.. SERVICE DESCRIPTION ~UNT BI~ AMOUNT ALLOWEE.j LESS INElIfiIQLE!~ AMOUNT PAID [M[ c: ':;fl':'Q94 ~HYSICAL M~D!CINE TR 'tQ.00 0.00 O.C\.i \.i.OO W149 (12 ~-7,~9~ oHYSICAL ,~r OIL. IHE TR 1Q6.00 0.00 O.C'; 0.00 W149 03 :7:"09/. oHYSICAL Mf DIe I HE TI\ 196.00 0.00 o.co c.OO W149 04 ~7:'794 "HYSICAL ,~fOICINE TR 196.00 0.00 0.00 0.00 W149 05 ,: 7Z, 791.. rHYSICAL MfOlCINE TR 196.(:0 0.00 0.00 \.t.ce W149 o~ ~ ,'~':':? 94 ~HYSICAL MHll ,;! NE TI\ 1'16.00 0.00 C.':'C 0.00 .1149 07 V,!C 394 ~HYSICAL MEOlr.INE TR 196.0G 0.00 n.ow (,.00 W149 08 0d:OQ4 PHYSICAL MfOICINE TR 196.0C 0.00 O.OG (;.00 W149 09 ,':;Sj" 094 oHYSICAL MfOI( IHE TR 191>.1')0 C.OO o .Cu O.CO W149 ... T 0 T t, ,- S ..* 16:7.00 0.00 C.Cu .,j.OO REASON r.or " ~; " 14" SE:RVICE WI. S rIOT AUTHORIZED F.Y THE PRIMARY CAf\E PHYS IC 1..'1. You are ~L rElspcnslbla far Bny dllfert1nce belween the amount billed Bnd Ihe amollnl paid lor any COlJfH8d Services, unloss an amount I~ specified In the "lESS INELIGIBLE AMOUNT" column, Pleal\e nt'"r 10 the explllnnflon Above for any Inellglbltt amounts, II your clatm has been denied In whole or In Pdrt, yOll have lhe right 10 l"equeIU 11 review To appeal 11 clAim tile fJ W'UTTIN AP'IAL WITHIN 10 DAYS AFTIR "ICIIVING THIS IXPLANATION 0' IINI"TS STATIMINT. Ploltse reter to tl"le 'GrieVAnce PrQcedure" Secllon of your Member Agraement 'or .1ctdllicnal tn'ormallon The appeal sholJld be sent to: KeystoOft Hoalth Plan Cenrral, Int:. Member S"~IC8$ Oepl. Su,. 8988t2, Camp HIli. PA t7089~8812 KeyItoM 111.111 PIM<!IJ' Cent...1 , Nt~ llClnMl otllW ~ IWCroIIMd"SIIlltIclANOC;1IDOn Kly.,on. Hllllh PI.n elnlral, Inc, P.o. Box 898812. e.mp Hili, PA 17089-8812 I I GE4P,y,J4~E"l 1508F HIGH P~I~TE OR HARRISBUQ~,~~ 17025 DAlE CLAIM NUMBER ~AIIENr NAME PROVIDER NAME PAID 10 CHECK NUMBER II you hovI qUllllon. Iboul thl. hpllnllion ot Blnlllll cI11 (717) 783-3B94 If oul 01 Ihl HI""bur~'orel, cllll~~22-2Ilo13, 03/13/95 43'J41380z.J'l GEARY,JAMES,l QCCUPATIJNA~ REHA6 & P,ESEA~C~ GE4P,Y ,JAME S, L NO CHECK L .J AGREEMENINUMBER U,46,469 GROUP NUMBER 1 36930 "".... SERV,CE OATE SERVICE OESCRIPIION EXPLANATION OF BENEFITS AMOUNT BILLEO AMOUNT ALLOWED lESS INElIGiOlE AMOUNT AMOUNT PAID C'l :~H94 THERAPEUT I ': PROC EOUR 60."0 0.00 0.00 c.: : q 31 ';4 rH~P,APEUTI~ ~R':lC<:OUP, 9 'i.~:> O.CI) I).OJ III T 0 T 4 l S III 15l?OO 0.00 ".0" REASON COt);:! : ,,:..~ ~ERVICE ..~S :IIOT AUTHORIZED ~Y THE i'RIMARY CARE PHYSICIAIIl. " a.oo '11149 oJ.oo '11149 v.OC You are not responsible for any difference between the amount bUled and the amount paId for any Covered 9.,vlclI, unl... In .mount II speCified mIn. 'LESS INELIGIBLE AMOUNT" column Please refer to the explanation above for any Ineligible amount,. If your clllm hi' b..n denied 10 whote t;lr In part. you h.:l\l8 !he rtght to requtJst a review To appeal a claIm file a W'UnIN "fIIIAL WITHIN 10 DAY' A'TI" "ICIIVINO THIS IXPLANATION 0' BINI"" STATlMINT, Pl.... r.l.r 10 th. "Grl."nce Procedur." "Cllon 01 you, Mlmber Agrolmlnt 'or addUionalln'~rmal.tJn The appeal should be sent 10. Keystone Health Plan Central. Ine.. Member SeNte.. Olpt Box 898812. Camp Hill. PA 1101f01112. (" ( ~ - It Keystone Health Plan, Central An IndtplndenllJc....H of m, B1ut Croll and Blut ShI.'d AIIIOCllllQn 12080_898812 Camp HIli, PA 17089.8812 1717)183.3458 . Fu(717) 971H58915 June 22, 1995 James Geary 1508F High Point Drive Harrisburg, PA 17025 Dear Ms, Geary: Keystone Health Plan Central (KHPC) recently considered your request for a review of KHPC's disallowance of services provided for yourself on April 26 to August 31, 1994, by Occupational Rehab and Research, When you enrolled in KHPC you agreed to use your Primary Care Provider to provide or arrange for all of your health care needs, This applies to any services arising from a motor vehicle accident, as well, even though another insurance carrier may be primary. Since motor vehicle insurance usually has a maximum payable amount, it is especially important to inform your Primary Care Provider so tl1at he can authorize any services that are in excess of the other insurance coverage, Since the above mentioned services were neither provided nor authorized by Susquehanna Internal Medicine Assoc., it has been decided that they are not eligible for payment under Keystone Health Plan Central. If you wish to pursue this matter further, you may submit a written appeal to the Initial Grievance Committee within 30 days of the receipt of this letter. If you have any questions regarding this procedure, you can contact our Member Service Department at (717)763-3894 or 1-800-622-2843. Sincerely, JS/rf I i J ce Shirey Senior Member Service Representative ~ +, ClIllillllllhll'Crn"" .'t'IIII.yhlllliu IlIUl'Shll'ld . . 1r\lll!lJl'n(jent L'(l!n~f1"!l ,:1 It'll! 8h,r! CI()!iS i.lnr1 81lm Shll~I(1 "~tir,cl,lllon , Ht'ql',hJIl'll Mune,> <.tltlP. Hllll! CrL)'iS ;Jnll Shill Sh'lllfJ ASSOCIIllIOI1 .lr1 A'>'>')(I,II,,)I' d 1'\110pen(1IH11 BIL,jrl Cl<\'l~' anrj Bhle Shlelr1 Plan!! FAMILy.PRACTICE ASSOCIATES A Hell,hAnwrlC' Mtr1i(lIOffice F. SAloMi F ABtR, M.D. MlCf'Atl P. HOHNlI1, M.D. M"",ON ), RUB'''S!tlN, M.D. 60'<'" L BURM~JM, M.D. . V'R'''' W, CRllN.R, O,Q. IANl PURl!, P.A.-C. CJ 2151 L1nglestown Road .Harrlsburg, PA 17110. (717) 652-5380 PHONE/17171 652-0812 FAX CJ 5 Willow Mill Park Road .M~chanicJburg, PA 17055. (717) 691-0202 PHONE/(717) 691-0946 FAX July 11, 1995 Keystone Health Plan Central 100 Senate Avenue Camp Hill, PA 17011 Re: James L. Geary, Jr. TO WHOM IT MAY CONCERN: Jawes Geary had been under my care prior to May 1, 199~. While under my care, James had been seen for injuries resultant from an automobile accident in April, 1993. He initially was cared for through the auto insurance, His benefits apparently reached maximum while he was in a course of physical therapy. He was undergoing physical therapy at the order of Dr. Rex Herbert for rehabilitation following a Neer acromioplasty of the left shoulder that was carried out on April 8, 1994. The reason for this letter is at the patient's request. Obviously, therapy is appropriate following a procedure such as he had undergone. Unfortunately, neither the consultant nor the patient nor the physical therapy office realized at the time that he had reached his maximal benefits under the auto insurance. He did require therapy through the end of August, 1994, which I feel was appropriate, again given the procedure that he had undergone. I am aware that K.H.P.C. has disallowed coverage of the ser.vices from late April through August 31, 1994, for that rehabilitation. I am writing this letter to request that you reconsider that rejection. Thank you for your attention to this matter. Very truly yours, ~{J&~ po Vernne W. Greiner, D.O.. VWG/alp cc: Anthony Stefanon & Glace HealthAmerlcs" . (' ( , " . , , . ~erDton. aealth Ju y 21, 1995 Paqe 2 of 2 Plan, Central I look forward to your early qrievance request. ini tial AS/djs Bnclosures pCI Jame. L. aeary, Jr. I' ' . , ... Keystone Health Plan. Central 300 Corporote Center Drive Suite 602 P,O, Box 898.3 12 Comp HIli. PA 17089.8812 (717)730-1719 . Fox (717)975-689~ IIobeIt S. Muac:alua. D.O. ASSOCIATE MEDICAL DIRECTOR September 8, 1995 Mr, James Geary 1508 F High Pointe Drive Harrisburg, Penn3ylvania 17025 Dear Mr. Geary: On September 6. 1995. the Inilial GrievWlce Committee of Keystone Health Plan Central. consisting of Alison Mcllwee, R.N" Appeals Coordinator, Lisa Frey, MWlager, Sales and Marketing De;lartment, Nancy Page. Manager of our Member Services Department, Brenda Laudenslager, Provider Relations Representative, Rosemary Baer, R.N, Quality Management Coordinator, and I met to discuss your grievancc as statcd in your letter, It is our understanding that you are requesting payment of physical therapy services received at Occupational Rehab and KeSeltrcil. mc., SIULUS pust motor vehicle accident on April 9, 1994. In making its decision, the Initial Grievance Committee considered the following: we reviewed letters from Anthony Stefanon. Esg.. dated May 26, 1995 and July 21, 1995, benefits statement outlined by Keystone Health Plan Central, a letter from Vemne W. Greiner, 0.0" dated July 11. 1995, medical record documentation from Occupational Rehab and Research Associates, Inc" and documentation of recent telephone conversation placed by you to our Member Services Department. Based upon our review of the above intormation. it was the decision of the Initial Grievance Committee to deny authorization for payment of physical therapy services at Occupational Rehab and Research, (nc.. status post motor vehicle accident on April 9, 1994. These services were obtained at an out-of-network facility. and they were no! coordinated nor were they authorized by your primary care physician, I have enclosed a copy of the cover of the Keystone lIealth Plan Central Subscriber Agreement which clearly indicates that benefits are covered only when provided or authorized by your primary care physician, KHP Cent,III,''''' HMO ,MII,ted Wilt'! 1...".".,..-....', L~_ '_(1~"\'" f '" tiVI;',!~t:l,~lrl I "II'" ,.~~:-, "I" " ",.':.,til'I",.,:j';l." , I . {1ft.~ ,j,,',dl.F1 '~.- " l'(t',' 1..."...1'" :"j ~""" -I~:';~\~l'-':"/:':lt:d .,~^"r""'."'/.\"'"'' ,I. ...,,'fi~'.' rl"Vtt,i', 1 .~t,..:' .-' , ,...' -', '; " "_" .,'li'." ..!~~ . B1ueSh1eld " JAMES L. GEARY, IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA Plaintiff v. No. 96-2166 KEYSTONE HEALTH PLAN CENTRAL, INC t/d/b/a KEYSTONE HEALTH PLAN CENTRAL, CIVIL ACTION - LAW Defendant JURY TRIAL DEMANDED PRILIMINARY OBJECTIONS Defendant, Keystone Health Plan central (KHPC), by its undersigned attorneys, makes the following preliminary objections to the complaint: A. AORlaMlNT roa ALTERNATIVE DISPUTB RBSOLUTION 1. KHPC is a health maintenance organization ("HMO"), certified to operate as such under the Pennsylvania Health Maintenance Organization Act ("the HMO Act"), 40 P.S. 551551- 1567. 2. Plaintiff is a party to a contract issued by KHPC (the "Subscriber Agreement"), pursuant to which KHPC is obligated to provide to plaintiff certain health care services, as more particularly set forth in the Subscriber Agreement. 3. The complaint alleges a dispute bet~ ,'en plaintiff and KHPC relating to KHPC's obligation to pay for health care services. Committee's decision will be binding, unless the member appeals the decision. 8. Since plaintiff was required by the Subscriber Agreement to submit his complaint to the grievance process, but failed to pursue that process to its conclusion, the complaint should be dismissed. B. DIMURRIR TO COUNT II or THI COMPLAINT 9. Count II of the complaint asserts a claim in bad faith, allegedly arising under 42 Pa. C.S. 58371. That section of the judicial code establishes a limited cause of action "in an action arising under an insurance DOlicv, if the court finds that the insurer has acted in bad faith toward the insured,..." 10. RHPC is not an insurer and the Subscriber Agreement is not an insurance policy. Rather, KHPC is a specialized entity organized under the HMO Act. 11. section 10 of the HMO Act, 40 P,S. 51560 provides: "(8) except as otherwise provided in this act, a health maintenance organization operating under the provisions of this Act shall not be subject to the laws of this state now in force relating to insurance corporations engaged in the business of insurance nor to any law hereafter enacted relating to the business of insurance unless such law specifically and in exact terms applies to such health maintenance organization..." 3 ~l 1,1.') q CJ\ 0 -/ " ~~. ,'" '!r~ r" '-1 .?; Ij W ',-/ T "1J " , ',.J ~. r~( ~ ,I'J ,., ~';; , .;... !('~ ZOO ..jf ,. ~- ~ .. .., .,.. :.1:1 ,=" :;'1 ~ CJl .... ..... JAMES L. GEARY, IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY PENNSYLVANIA Plaintiff v. KEYSTONE HEALTH PLAN CENTRAL INC. t/d/b/a KEYSTONE HEALTH PLAN CENTRAL, NO. 96-2166 CIVIL ACTION LAW JURY TRIAL DEMANDED Defendant PRAECIPB POR DISCO~INUANC. TO THE PROTHONOTARY: Mark the above captioned action DISCONTINUED. By: ANTHONY. 1.0. #254 407 Nor! Fro Street P.O. Box 7 Harrisburg, PA 17108-2027 (717) 232-0511 DATE: -1. 2,1- ,..9 , I ", e .0 q F .0 0, r/) "'J 'Moor~; ,'"' I,...." (,9q: "V Iii':": ~._.. ; 1') IIi"! ":,..' r . ,,"') (jj ,): .-- I,") (l, .' ~.,~ ., . :Jf ':; ~ ...; -0 'j:';l }:;(", :=t; '.,() ~r;"": C'" ~ . .~~ n 1 ~.~ >.1 .; "'.. , , -, ~ UI