Continuity of Care from Plan Providers. Termination of a Plan Provider’s contract will not release the Provider from treating an Insured, except for reasons of medical incompetence or professional misconduct as determined by SHL. Coverage provided under this section is available until the latest of the following dates: The 120th day following the date the contract was terminated between the Provider and SHL; or If the medical condition is Complication of Pregnancy, the 45th day after the date of delivery or if the pregnancy does not end in delivery the date of the end of the pregnancy. The Insured or Plan Provider may submit a request for continuity of care to the address shown below. If the Plan agrees to the continued treatment, the Plan will pay for Covered Services at the Plan Provider level of benefits for a limited time, as outlined above. The Plan Provider may not seek payment from the Insured for any amounts for which the Insured would not be responsible if the Provider were still a Plan Provider. Sierra Health and Life Insurance Co., Inc. Attn: Provider Services Department XX Xxx 00000 Xxx Xxxxx, XX 00000-0000 Phone: 000-000-0000
Continuity of Care from Plan Providers. Termination of a Plan Provider’s contract will not release the Provider from treating a Member, except for reasons of medical incompetence or professional misconduct as determined by HPN. Coverage provided under this section is available until the latest of the following dates: The 120th day following the date the contract was terminated between the Provider and HPN; or If the medical condition is pregnancy, the 90th day after the date of delivery or if the pregnancy does not end in delivery, the date of the end of the pregnancy. The Member or Plan Provider may submit a request for continuity of care to the address shown below. If the Plan agrees to the continued treatment, the Plan will pay for Covered Services at the Plan Provider level of benefits for a limited time, as outlined above. The Plan Provider may not seek payment from the Member for any amounts for which the Member would not be responsible if the Provider were still a Plan Provider. Agreement of Coverage Health Plan of Nevada, Inc. Attn: Provider Services Dept. P.O. Box 15645 Las Vegas, NV 89114-5645 888-293-6831
Continuity of Care from Plan Providers. Make timely payment of Copayment amounts due to Providers. Termination of a Plan Provider’s contract will not release the Provider from treating a Member, except for reasons of medical incompetence or professional misconduct as determined by HPN. Coverage provided under this section is available until the latest of the following dates: • The 120th day following the date the contract was terminated between the Provider and HPN; or • If the medical condition is pregnancy, the 45th day after the date of delivery or if the pregnancy does not end in delivery the date of the end of the pregnancy. The Member or Plan Provider may submit a request for continuity of care to the address shown below. If the Plan agrees to the continued treatment, the Plan will pay for Covered Services at the Plan Provider level of benefits for a limited time, as outlined above. The Plan Provider may not seek payment from the Member for any amounts for which the Member would not be responsible if the Provider were still a Plan Provider. Address: Health Plan of Nevada, Inc. Attn: Provider Services Dept. X.X. Xxx 00000 Xxx Xxxxx, XX 00000-0000 Phone: (000) 000-0000 0-000-000-0000
Continuity of Care from Plan Providers. All decisions of SHL’s Managed Care Program may be appealed by the Insured or his Authorized Representative through the Appeals Procedures. If an imminent and serious threat to the health of the Insured exists, the appeal will be directed to SHL's Medical Director.
Continuity of Care from Plan Providers. Termination of a Plan Provider’s contract will not release the Provider from treating a Member, except for reasons of medical incompetence or professional misconduct as determined by HPN. Coverage provided under this section is available until the latest of the following dates:
Continuity of Care from Plan Providers. Termination of a Plan Provider’s contract will not release the Provider from treating a Member, except for reasons of medical incompetence or professional misconduct as determined by HPN. Coverage provided under this section is available until the latest of the following dates: • The 120th day following the date the contract was terminated between the Provider and HPN; or • If the medical condition is pregnancy, the 45th day after the date of delivery or if the pregnancy does not end in delivery the date of the end of the pregnancy. The Member or Plan Provider may submit a request for continuity of care to the address shown below. If the Plan agrees to the continued 0-000-000-0000 (English) 0-000-000-0000 (Español)
Continuity of Care from Plan Providers. Semiprivate (or multibed unit) room, including bed, board, and general nursing care. Private room including bed, board, and general nursing care, but only when treatment of the Member's condition requires a private room. The semiprivate room rate will be allowed toward the private room rate when a Member receives private room accommodations for any reason other than Medical Necessity. Inpatient accommodations provided in connection with the birth of a child shall be provided for a minimum of forty-eight (48) hours following an uncomplicated vaginal delivery or a minimum of ninety-six (96) hours following an uncomplicated delivery by cesarean section. This provision does not require a Member to deliver in a Hospital or other healthcare facility or to remain therein for the minimum number of hours following delivery. Intensive care unit (including Cardiac Care Unit), including bed, board, general and special nursing care, and ICU equipment. Observation unit, including bed, board, and general nursing care not to exceed twenty-three (23) hours. Nursery charges for newborns. Reimbursement for Covered Services provided by a Non-Plan Provider outside HPN’s Service Area to a newborn natural child or adopted child is limited to HPN’s Eligible Medical Expense for similar Covered Services provided in HPN's Service Area. Services and Supplies. Covered Services and supplies provided by a Hospital, Ambulatory Surgical Facility, Skilled Nursing Facility, or Hospice Care Facility include: operating, recovery, and treatment rooms and equipment (Hospital and Ambulatory Surgical Facility only); delivery and labor rooms and equipment (Hospital and Ambulatory Surgical Facility only); anesthesia materials and anesthesia administration by Hospital staff (Hospital and Ambulatory Surgical Facility only); clinical pathology and laboratory services and supplies; services and supplies for diagnostic tests required to diagnose Member's Illness, Injury or other conditions but only when charges for the services and/or supplies are made by the facility (Hospital, Skilled Nursing Facility and Ambulatory Surgical Facility only); drugs consumed at the time and place dispensed which have been approved for general marketing in the United States by the Food and Drug Administration (FDA); dressings, splints, casts and other supplies for medical treatment provided by the Hospital from a central sterile supply department; oxygen and its administration; non-replaced b...
Continuity of Care from Plan Providers. Termination of a Plan Provider’s contract will not release the Provider from treating an Insured, except for reasons of medical incompetence or professional misconduct as determined by SHL. Coverage provided under this section is available until the latest of the following dates: • The 120th day following the date the contract was terminated between the Provider and SHL; or
