Covered Inpatient Hospital Services. A Member will receive benefits for the Covered Services listed below when admitted to a Contracting Provider hospital under the care of a Primary Care Physician or other Contracting Provider. Coverage of inpatient hospital services is subject to certification by utilization management for Medical Necessity. Except for maternity and Emergency admissions, prior authorization is required. Contracting Providers will obtain prior authorization on behalf of the Member. Benefits are provided for: A. Room and Board. Room and board in a semiprivate room (or in a private room when Medically Necessary as determined by CareFirst BlueChoice). SAMPLE
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Samples: Individual Enrollment Agreement for a Qualified Health Plan, Individual Enrollment Agreement for a Qualified Health Plan, Individual Enrollment Agreement
Covered Inpatient Hospital Services. A Member will receive benefits for the Covered Services listed below when admitted to a Contracting Provider hospital under the care of a Primary Care Physician or other Contracting Provider. Coverage of inpatient hospital services is subject to certification by utilization management for Medical Necessity. Except for maternity and Emergency admissions, prior authorization pre-admission review is required. Contracting Providers will obtain prior authorization on behalf of the Member. Benefits are provided for:
A. Room and Board. Room and board in a semiprivate room (or in a private room when Medically Necessary as determined by CareFirst BlueChoice). SAMPLE
Appears in 1 contract
