Anesthesia Services. We cover medically necessary anesthesia services received from an anesthesiologist when the services are for a covered procedure. Our allowance for the anesthesia service includes the following: • anesthesia care during the procedure; • time an anesthesiologist routinely spends with a patient in the recovery room; • time spent preparing the patient for surgery; and • pre-operative consultations. Our allowance for the surgical procedure includes local anesthesia. Other than the pre-operative office visit, this agreement covers office visits or office consultations to anesthesiologists as an office visit. See Section 3.23 - Office Visits. Anesthesia services when rendered at a hospital or free-standing ambulatory surgi-center in connection with a dental service are covered when the use of the hospital or free-standing ambulatory surgi-center is medically necessary and the setting in which the service received is determined to be appropriate. Preauthorization is recommended for this service. The dental services will remain non-covered. See Section 4.17.
Appears in 2 contracts
Samples: Subscriber Agreement, Subscriber Agreement
Anesthesia Services. We cover medically necessary anesthesia services received from an anesthesiologist when the services are for related to a covered procedure. Our allowance for the anesthesia service includes the following: • anesthesia care during the procedure; • , time an anesthesiologist routinely spends with a patient in the recovery room; • , time spent preparing the patient for surgery; , and • pre-for pre- operative consultations. Our allowance for the surgical procedure includes local anesthesia. Epidural anesthesia services administered at the base of the spine is covered only when administered during a covered obstetrical procedure. Anesthesia administered by an anesthesiologist for electroconvulsive therapy is covered. See Section 3.2 - Behavioral Health Services - Mental Health Services. Other than the pre-operative office visit, this agreement covers office visits or and/or office consultations to anesthesiologists as an office visit. See Section 3.23 3.24 - Office Visits. Anesthesia services when rendered at a hospital or free-standing ambulatory surgi-center in connection with a dental service are covered when the use of the hospital or free-standing ambulatory surgi-center is medically necessary and the setting in which the service received is determined to be appropriate. Preauthorization is recommended for this service. The dental services will remain non-covered. See Section 4.175.17.
Appears in 2 contracts
Samples: Subscriber Agreement, Subscriber Agreement
Anesthesia Services. We cover medically necessary anesthesia services received from an anesthesiologist when the services are for a covered procedure. Our allowance for the anesthesia service includes the following: • anesthesia care during the procedure; • time an anesthesiologist routinely spends with a patient in the recovery room; • time spent preparing the patient for surgery; and • pre-operative consultations. Our allowance for the surgical procedure includes local anesthesia. Other than the pre-operative office visit, this agreement covers office visits or office consultations to anesthesiologists as an office visit. See Section 3.23 3.24 - Office Visits. Anesthesia services when rendered at a hospital or free-standing ambulatory surgi-center in connection with a dental service are covered when the use of the hospital or free-standing ambulatory surgi-center is medically necessary and the setting in which the service received is determined to be appropriate. Preauthorization is recommended for this service. The dental services will remain non-covered. See Section 4.174.18.
Appears in 1 contract
Samples: Subscriber Agreement