Dialysis Treatment Clause Samples

Dialysis Treatment. Dialysis treatment is a Covered Service. If an Out-of-Network Provider is elected, then out-of- network benefits apply. Your plan will pay the rental charge up to the lesser of the purchase price of the equipment or twelve (12) months of rental charges. In addition to meeting criteria for Medical Necessity, the equipment must also be used to improve the functions of a malformed part of the body or to prevent or slow further decline of the Member’s medical condition. The equipment must be ordered and/or prescribed by a Physician and be appropriate for in-home use. The equipment must meet the following criteria: • It can stand repeated use; • It is manufactured solely to serve a medical purpose; • It is not merely for comfort or convenience; • It is normally not useful to a person not ill or injured; • It is ordered by a Provider; • The Provider certifies in writing the Medical Necessity for the equipment. o The Provider also states the length of time the equipment will be required; o We may require proof at any time of the continuing Medical Necessity of any item; • It is related to the patient’s physicaldisorder. Coverage is provided for Hospital emergency room care for initial services rendered for the onset of symptoms for an emergency medical condition or serious Accidental Injury which requires immediate medical care. If you require emergency care, go to the emergency room or call 911.

Dialysis Treatment. The treatment of acute renal failure or chronic irreversible renal insufficiency to include hemodialysis or peritoneal dialysis. Dialysis treatment may include home dialysis, when required criteria are met. NOTE: this service requires preauthorization.

Dialysis Treatment. Dialysis treatment is a Covered Service. If an Out-of-Network Provider is elected, then out-of- network benefits apply. For covered equipment, Alliant will pay a rental charge up to the purchase price of the equipment. In addition to meeting criteria for Medical Necessity, the equipment must also be used to improve the functions of a malformed part of the body or to prevent or slow further decline of the Member’s medical condition. The equipment must be ordered and/or prescribed by a Physician and be appropriate for in-home use. The equipment must meet the following criteria: • It can stand repeated use; • It is manufactured solely to serve a medical purpose; • It is not merely for comfort or convenience; • It is normally not useful to a person not ill orinjured; • It is ordered by a Provider; • The Provider certifies in writing the Medical Necessity for the equipment. o The Provider also states the length of time the equipment will be required; o We may require proof at any time of the continuing Medical Necessity of anyitem; • It is related to the patient’s physical disorder. Coverage is provided for Hospital emergency room care for initial services rendered for the onset of symptoms for an emergency medical condition or serious Accidental Injury which requires immediate medical care. If you require emergency care, go to the emergency room or call 911.

Dialysis Treatment. Pulmonary Rehabilitation Therapy is limited to a Maximum of eighteen (18) visits or as indicated on the Outline of Coverage per Benefit Period.

Dialysis Treatment. Benefits for dialysis include the Inpatient or Outpatient treatment of acute renal failure or chronic renal insufficiency for removal of waste materials from the body.