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Who is responsible for any amount(s) charged by an Out-Of- Network provider that exceed the maximum allowable fee?

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Who is responsible for any amount(s) charged by an Out-Of- Network provider that exceed the maximum allowable fee?

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A. Payments for charges submitted by Out-Of-Network providers will be limited to the maximum allowable fee as defined in the Glossary Section of your Certificate and any amount(s) charged that exceed this limitation will be the member’s responsibility.

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