Not Medically Necessary
Plan shall provide written documentation and detailed reason, to both Provider and Participant, of any utilization management determination that services are not Medically Necessary.  Hospital may seek payment from a Covered Person for services determined to be not Medically Necessary pursuant to the Utilization Management Program pursuant to this Agreement if Hospital obtains written consent to such payment for Covered Person prior to rendering services.  For the purposes of this Section ______, Hospital's Conditions of Admission shall serve as Covered Persons written consent to such payment.