Ambulatory Surgery Centers Sample Clauses

Ambulatory Surgery Centers. Health Care Services rendered at Ambulatory Surgery Centers are covered and include:
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Ambulatory Surgery Centers. Many of the more common, uncomplicated, outpatient surgical procedures can be performed at an Ambulatory Surgery Center. Your cost at an Ambulatory Surgery Center may be less than it would be for the same outpatient surgery performed at a Hospital. Timely access to care Participating Providers agree to provide timely access to care. This means that when you call for an appointment, you will see your provider within a reasonable timeframe. Blue Shield’s access standards are listed below. When your appointment will occur Urgent appointments Appointment will occur Services that do not require prior authorization Within 48 hours Services that do require prior authorization Within 96 hours Non-urgent appointments Appointment will occur Primary Care Physician office visit Within 10 business days Specialist office visit Within 15 business days Mental or substance use disorder health provider (who is not a Physician) office visit Within 10 business days When your appointment will occur Other services to diagnose or treat a health condition Within 15 business days Phone inquiries Appointment will occur Access to a health care professional for phone screenings 24 hours a day, seven days a week Contact Customer Service to schedule interpreter services for your appointment. For more information about interpreter services, see the Language access services notice. Health advice and education Blue Shield provides several ways for you to get health advice and access to health education and wellness services. These resources are available to you at no extra cost. NurseHelp 24/7SM You can contact a registered nurse 24 hours a day, seven days a week through the NurseHelp 24/7SM program. Nurses are available to help you select appropriate care and answer questions about: • Symptoms you are experiencing; • Minor illnesses and injuries; • Medical tests and medications; • Chronic conditions; and • Preventive care. Call (000) 000-0000 or log in to your account at xxxxxxxxxxxx.xxx and use the chat feature to connect with a nurse. This service is free and confidential. NurseHelp 24/7 SM is not meant to replace the advice and care you receive from your Physician or other health care professional.
Ambulatory Surgery Centers. The Plan provides Benefits for certain Covered Services provided by Ambulatory Surgery Centers that align with state and federal regulations. Covered Services vary according to the scope of a specific Ambulatory Surgical Center’s license. Ambulatory services are not to exceed 24 hours.
Ambulatory Surgery Centers. Health Care Services rendered at in-network Ambulatory Surgery Centers are covered and include:
Ambulatory Surgery Centers. All outpatient services provided in an ambulatory surgery center will be priced based on 200% of the then current Medicare ASC allowable rates, geographically adjusted.
Ambulatory Surgery Centers. Many of the more common, uncomplicated, outpatient surgical procedures can be performed at an Ambulatory Surgery Center. Your cost at an Ambulatory Surgery Center may be less than it would be for the same outpatient surgery performed at a Hospital. Evaluations and services under the CARE Act Blue Shield covers the cost of developing an evaluation and the provision of all health care services for an enrollee when required or recommended pursuant to a CARE (Community Assistance, Recovery, and Empowerment) agreement or CARE plan approved by a court in accordance with the CARE Act. The evaluation and services, other than prescription Drugs, are covered at no charge whether they are provided by a Participating or Non-Participating Provider.

Related to Ambulatory Surgery Centers

  • Surgery a) The performance of generally accepted operative and cutting procedures, including surgical diagnostic procedures, specialized instrumentations, endoscopic examinations, and other procedures;

  • Prosthodontics We Cover prosthodontic services as follows: • Removable complete or partial dentures, for Members 15 years of age and above, including six (6) months follow-up care; • Additional services including insertion of identification slips, repairs, relines and rebases and treatment of cleft palate; and • Interim prosthesis for Members five (5) to 15 years of age. We do not Cover implants or implant related services. Fixed bridges are not Covered unless they are required: • For replacement of a single upper anterior (central/lateral incisor or cuspid) in a patient with an otherwise full complement of natural, functional and/or restored teeth; • For cleft palate stabilization; or • Due to the presence of any neurologic or physiologic condition that would preclude the placement of a removable prosthesis, as demonstrated by medical documentation.

  • Orthodontics We Cover orthodontics used to help restore oral structures to health and function and to treat serious medical conditions such as: cleft palate and cleft lip; maxillary/mandibular micrognathia (underdeveloped upper or lower jaw); extreme mandibular prognathism; severe asymmetry (craniofacial anomalies); ankylosis of the temporomandibular joint; and other significant skeletal dysplasias. Procedures include but are not limited to: • Rapid Palatal Expansion (RPE); • Placement of component parts (e.g. brackets, bands); • Interceptive orthodontic treatment; • Comprehensive orthodontic treatment (during which orthodontic appliances are placed for active treatment and periodically adjusted); • Removable appliance therapy; and • Orthodontic retention (removal of appliances, construction and placement of retainers).

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