Refers to the entity responsible for payment when a third party may be the cause of an accident or injury to a person, be it an automobile, work-related or personal. rgent Care Covered services required to prevent serious deterioration of a member's health that results from an unforeseen illness or injury if either of the following conditions are met: The member is temporarily absent from the health care organization's service area, and the services cannot be delayed until the member returns to the area, or The PCP or provider office is not accessible and services are not emergent, but cannot be delayed until the next business day.