102 General Provisions Care Coordination Anthems, as the Claims Administrator, pays Participating Providers in various ways to provide Covered Services to you. For example, sometimes the Claims Administrator may pay Participating Providers a separate amount for each Covered Service they provide. The Claims Administrator may also pay them one amount for all Covered Services related to treatment of a medical condition. Other times, the Claims Administrator may pay a periodic, fixed pre-determined amount to cover the costs of Covered Services. In addition, the Claims Administrator may pay Participating Providers financial incentives or other amounts to help improve quality of care and/or promote the delivery of health care services in a cost-efficient manner, or compensate Participating Providers for coordination of Member care. In some instances, Participating Providers may be required to make payment to the Claims Administrator because they did not meet certain standards. You do not share in any payments made by Participating Providers to the Claims Administrator under these programs. Clerical Error A clerical error will never disturb or affect your coverage, as long as your coverage is valid under the rules of the Plan. This rule applies to any clerical error, regardless of whether it was the fault of the Employer or the Plan. Confidentiality and Release of Information Applicable state and federal law requires the Claims Administrator to undertake efforts to safeguard your medical information. For informational purposes only, please be advised that a statement describing the Claims Administrator’s policies and procedures regarding the protection, use and disclosure of your medical information is available on the Claims Administrator’s website and can be furnished to you upon request by contacting the Claims Administrator’s Member Services department. Obligations that arise under state and federal law and policies and procedures relating to privacy that are referenced but not included in this Booklet are not part of the contract between the parties and do not give rise to contractual obligations. Conformity with Law Any term of the Plan which is in conflict with federal law, will hereby be automatically amended to conform with the minimum requirements of such laws. Contract with Anthem The Employer, on behalf of itself and its participants, hereby expressly acknowledges its understanding that this Plan constitutes a Contract solely between the Employer and the Claims Administrator, Anthem Insurance Companies, Inc. dba Anthem Blue Cross and Blue Shield (Anthem), and that Anthem is an independent corporation licensed to use the Blue Cross and Blue Shield names and marks in the state of Indiana. The Blue Cross Blue Shield marks are registered by the Blue Cross and Blue Shield Association, an association of independently licensed Blue Cross and Blue Shield plans, with the U.S. Patent and Trademark Office in Washington, D.C. and in other countries. Further, Anthem is not contracting as the agent of the Blue Cross and Blue Shield Association or any other Blue Cross and/or Blue Shield plan or licensee. The Employer, on behalf of itself and its participants, further acknowledges
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