Coverage of Services Ultimately Determined to be Non-Emergencies. The Contractor shall not retroactively deny a Claim for an emergency screening examination because the Condition, which appeared to be an Emergency Medical Condition, turned out to be non-emergency in nature.
Appears in 3 contracts
Samples: Contract for Health Services Administration (Triple-S Management Corp), Contract for Health Services Administration (Triple-S Management Corp), Contract for Administration of Health Services (Triple-S Management Corp)
Coverage of Services Ultimately Determined to be Non-Emergencies. The Contractor shall not retroactively deny a Claim for an emergency screening examination because the Conditioncondition, which appeared to be an Emergency Medical ConditionCondition or a Psychiatric Emergency under the prudent layperson standard, turned out to be non-emergency in nature.
Appears in 2 contracts
Samples: Contract for Provision of Health Services (Triple-S Management Corp), Contract for Provision of Health Services
Coverage of Services Ultimately Determined to be Non-Emergencies. The Contractor shall not retroactively deny a Claim for an emergency screening examination because the Condition, which appeared to be an Emergency Medical ConditionCondition under the prudent layperson standard, turned out to be non-emergency in nature.
Appears in 1 contract
