Biofeedback Sample Clauses

Biofeedback. Biofeedback is only Covered for treatment of Raynaud’s disease or phenomenon and urinary or fecal incontinence. As a Presbyterian Health Plan Member, there will be no cost to you for anything related to COVID-19 screening, testing, medical treatment, or vaccination, including boosters. You will not pay copays, deductibles or coinsurance for visits related to COVID-19, whether at a clinic, hospital or using remote care. If you are on a high deductible plan (HDHP), these services will also be provided to you at no cost. This benefit has one or more exclusions as specified in the Exclusions Section. Dental benefits will be provided in connection with the following conditions when deemed Medically Necessary except in an emergency situation as described in the Accidental Injury (trauma), Urgent Care, Emergency Healthcare Services and Observation Services Section. Covered Services are as follows: · Accidental Injury to sound natural teeth, jawbones or surrounding tissue. Dental injury caused by chewing, biting, or Malocclusion is not considered an Accidental Injury and will not be Covered. · The correction of non-dental physiological conditions such as, but not limited to, cleft palate repair that has resulted in a severe functional impairment. · The treatment for tumors and cysts requiring pathological examination of the jaws, cheeks, lips, tongue, roof and floor of the mouth. · Hospitalization, day surgery, Outpatient and/or anesthesia for non- Covered dental services, are Covered, if provided in a Hospital or ambulatory surgical center for dental surgery, with our approval of a Prior Authorization request. Plan benefits for these services include coverage: o For Members who exhibit physical, intellectual or medically compromising conditions for which dental treatment under local anesthesia, with or without additional adjunctive techniques and modalities cannot be expected to provide a successful result and for which dental treatment under general anesthesia can be expected to produce superior results. o For Members for whom local anesthesia is ineffective because of acute infection, anatomic variation or allergy. o For Covered Dependent children or adolescents who are extremely uncooperative, fearful, anxious, or uncommunicative with dental needs of such magnitude that treatment should not be postponed or deferred and for whom lack of treatment can be expected to result in dental or oral pain or infection, loss of teeth or other increased oral or dental morbi...
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BiofeedbackMedically necessary health care services, including equipment and supplies, that are prescribed by your provider for the management and treatment of type I diabetes, type II diabetes, and/or gestational diabetes; and
Biofeedback. For any claim submitted by non lock-in pharmacy while member is in lock-in status. To facilitate appropriate benefit use and prevent opioid overutilization, member's participation in lock-in status will be determined by review of pharmacy claims.
Biofeedback. Biofeedback is only Covered for treatment of Raynaud’s disease or phenomenon and urinary or fecal incontinence. As a Presbyterian Health Plan member, there will be no cost to you for anything related to COVID-19 screening, testing, medical treatment, or vaccination, including boosters. You will not pay Copays, Deductibles or Coinsurance for visits related to COVID-19, whether at a clinic, Hospital or using remote care. This benefit has one or more exclusions as specified in the Exclusions Section. Dental benefits will be provided in connection with the following conditions when deemed Medically Necessary except in an emergency situation as described in the Accidental Injury (Trauma), Urgent Care, Emergency Healthcare Services and Observation Services Section. Covered Services are as follows: Accidental Injury to sound natural teeth, jawbones or surrounding tissue. Dental injury caused by chewing, biting, or Malocclusion is not considered an Accidental Injury and will not be Covered. The correction of non-dental physiological conditions such as, but not limited to, cleft palate repair that has resulted in a severe functional impairment. The treatment for tumors and cysts requiring pathological examination of the jaws, cheeks, lips, tongue, roof and floor of the mouth. Hospitalization, day surgery, Outpatient and/or anesthesia for non- Covered dental services, are Covered, if provided in a Hospital or ambulatory surgical center for dental surgery, a Prior Authorization may be required. Plan benefits for these services include coverage: o For Members who exhibit physical, intellectual or medically compromising conditions for which dental treatment under local anesthesia, with or without additional adjunctive techniques and modalities cannot be expected to provide a successful result and for which dental treatment under general anesthesia can be expected to produce superior results. o For Members for whom local anesthesia is ineffective because of acute infection, anatomic variation or allergy. o For Covered Dependent children or adolescents who are extremely uncooperative, fearful, anxious, or uncommunicative with dental needs of such magnitude that treatment should not be postponed or deferred and for whom lack of treatment can be expected to result in dental or oral pain or infection, loss of teeth or other increased oral or dental morbidity. o For Members with extensive oral-facial or dental trauma for which treatment under local anesthesia would be ineffe...
Biofeedback. Upper and lower jawbone surgery, orthognathic surgery, and jaw alignment. This exclusion does not apply to reconstructive jaw surgery required for you because of a Congenital Anomaly, acute traumatic Injury, dislocation, tumors, cancer or obstructive sleep apnea. This exclusion does not apply to reduction of a dislocation or fracture of the jaw or facial bone; excision of a benign or malignant tumor of the jaw; and orthognathic surgery that you need to correct a significant functional impairment that cannot be adequately corrected with orthodontic services. You must have a serious medical condition that requires that you be admitted to a Hospital as an inpatient in order for the surgery to be safely performed.
BiofeedbackServices for the evaluation and treatment of Temporomandibular Joint Syndrome (TMJ), whether the services are considered to be medical or dental in nature.
Biofeedback. The following services for the diagnosis and treatment of Temporomandibular Joint Syndrome (TMJ): surface electromyography; Doppler analysis; vibration analysis; computerized mandibular scan or jaw tracking; craniosacral therapy; orthodontics; occlusal adjustment; and dental restorations.
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Biofeedback. Biofeedback is only Covered for treatment of Raynaud’s disease or phenomenon and urinary or fecal incontinence. As a Presbyterian Insurance Company member, there will be no cost to you for anything related to COVID-19 screening, testing or medical treatment. You will not pay Copays, Deductibles or Coinsurance for visits related to COVID-19, whether at a clinic, Hospital or using remote care. If you are on a high deductible plan (HDHP), these services will also be provided to you at no cost.
Biofeedback. Biofeedback is only Covered for treatment of Raynaud’s disease or phenomenon and urinary or fecal incontinence. This benefit has one or more exclusions as specified in the Exclusions Section. Dental benefits will be provided in connection with the following conditions when deemed Medically Necessary except in an emergency situation as described in the Accidental Injury (trauma), Urgent Care, Emergency Health Care Services and Observation Services Section. Covered Services are as follows: • Accidental Injury to sound natural teeth, jawbones or surrounding tissue. Dental injury caused by chewing, biting, or Malocclusion is not considered an Accidental Injury and will not be Covered. • The correction of non-dental physiological conditions such as, but not limited to, cleft palate repair that has resulted in a severe functional impairment. • The treatment for tumors and cysts requiring pathological examination of the jaws, cheeks, lips, tongue, roof and floor of the mouth. • Hospitalization, day surgery, Outpatient and/or anesthesia for non- Covered dental services, are Covered, if provided in a Hospital or ambulatory surgical center for dental surgery, with our approval of a Prior Authorization request. Plan benefits for these services include coverage: o For Members who exhibit physical, intellectual or medically compromising conditions for which dental treatment under local anesthesia, with or without additional adjunctive techniques and modalities cannot be expected to provide a successful result and for which dental treatment under general anesthesia can be expected to produce superior results. o For Members for whom local anesthesia is ineffective because of acute infection, anatomic variation or allergy. o For Covered Dependent children or adolescents who are extremely uncooperative, fearful, anxious, or uncommunicative with dental needs of such magnitude that treatment should not be postponed or deferred and for whom lack of treatment can be expected to result in dental or oral pain or infection, loss of teeth or other increased oral or dental morbidity. o For Members with extensive oral-facial or dental trauma for which treatment under local anesthesia would be ineffective or compromised. o For other procedures for which Hospitalization or general anesthesia in a Hospital or ambulatory surgical center is Medically Necessary. • Oral surgery that is Medically Necessary to treat infections or abscess of the teeth that involved the fascia or have spread b...
BiofeedbackTelemedicine services may include interactive audio and video communications, permitting real time communication between a distant site provider of health care services and the member, who is present and participating in the televideo visit at a remote provider office.
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