Common use of Dental Procedures Clause in Contracts

Dental Procedures. The Plan provides Benefits for general anesthesia and associated facility charges for the Medically Necessary Hospital or surgical day care facility charges and administration of general anesthesia administered by a licensed anesthesiologist or anesthetist for dental procedures performed on a Member who is classified as vulnerable. Examples of vulnerable Members include, but are not limited to the following: a. Infants; b. Individuals exhibiting 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 a superior result; c. Individuals with acute infection; d. Individuals with allergies; e. Individuals who have sustained extensive oral-facial, or dental trauma; and f. Individuals who are extremely uncooperative, fearful, or anxious.

Appears in 3 contracts

Samples: Member Benefit Agreement, Member Benefit Agreement, Member Benefit Agreement

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Dental Procedures. The Plan provides Benefits for general anesthesia and associated facility charges for the Medically Necessary Hospital or surgical day care facility charges and administration of general anesthesia administered by a licensed anesthesiologist or anesthetist for dental procedures performed on a Member who is classified as vulnerable. Examples of vulnerable Members include, but are not limited to the following: a. Infants; b. Individuals exhibiting 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 a superior result; c. Individuals with acute infection; d. Individuals with allergies; e. Individuals who have sustained extensive oral-facial, or dental trauma; and f. Individuals who are extremely uncooperative, fearful, or anxious. The Plan does not provide Benefits under this section for any dental procedures or the dentist’s fee.

Appears in 1 contract

Samples: Member Benefit Agreement

Dental Procedures. The Plan provides Benefits for general anesthesia and associated facility charges for the Medically Necessary Hospital or surgical day care facility charges and administration of general anesthesia administered by a licensed anesthesiologist or anesthetist for dental procedures performed on a Member who is classified as vulnerable. Examples of vulnerable Members include, but are not limited to the following: a. Infants; b. Individuals exhibiting exhibit ing 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 treat ment under general anesthesia can be expected to produce a superior result; c. Individuals with acute infection; d. Individuals with allergies; e. Individuals who have sustained extensive oral-oral - facial, or dental trauma; and f. Individuals who are extremely uncooperativeuncooperat ive, fearful, or anxious.

Appears in 1 contract

Samples: Member Benefit Agreement

Dental Procedures. The Plan provides Benefits for general anesthesia and associated facility charges for the Medically Necessary Hospital or surgical day care facility charges and administration of general anesthesia administered by a licensed anesthesiologist or anesthetist for dental procedures performed on a Member who is classified as vulnerable. Examples of vulnerable Members include, but are not limited to the following: a. Infants; b. Individuals exhibiting 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 a superior result; c. Individuals with acute infection; d. Individuals with allergies; e. Individuals who have sustained extensive oral-facialoral‐facial, or dental trauma; and f. Individuals who are extremely uncooperative, fearful, or anxious. The Plan does not provide Benefits under this section for any dental procedures or the dentist’s fee.

Appears in 1 contract

Samples: Member Benefit Agreement

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Dental Procedures. The Plan provides Benefits for general anesthesia and associated facility charges for the Medically Necessary Hospital or surgical day care facility charges and administration of general anesthesia administered by a licensed anesthesiologist or anesthetist for dental procedures performed on a Member who is classified as vulnerable. Examples of vulnerable Members include, but are not limited to the following: a. Infants;; SAMPLE b. Individuals exhibiting 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 a superior result; c. Individuals with acute infection; d. Individuals with allergies; e. Individuals who have sustained extensive oral-facial, or dental trauma; and f. Individuals who are extremely uncooperative, fearful, or anxious. The Plan does not provide Benefits under this section for any dental procedures or the dentist’s fee.

Appears in 1 contract

Samples: Member Benefit Agreement

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