Emergency Admission. An Inpatient Admission to a Hospital that results from an Emergency Medical Condition. Emergency Medical Services – Those services that are necessary to screen, evaluate, and stabilize an Emergency Medical Condition.
Emergency Admission. This is an admission where the physician admits the person to the hospital or residential treatment facility right after the sudden and at that time; unexpected onset of a change in a person's physical or mental condition which: • Requires confinement right away as a full-time inpatient; and • If immediate inpatient care was not given could; as determined by Aetna; reasonably be expected to result in: - loss of life or limb; or - significant impairment to bodily function; or - permanent dysfunction of a body part.
Emergency Admission. 4.10 In case of a vehicular accident, if the victim was under influence of alcohol or inebriating drugs, since the insurance drugs, since the insurance does not cover this no pre-authorization will be given. It is mandatory for the provider to inform the cause of emergency for Grand Healthcare to issue pre-authorization.
4.11 In case of other emergencies the provider should call up the help desk of Grand Healthcare for guarantee of payment. Grand Healthcare may continue to discuss with treating doctor till conclusion of eligibility of coverage is arrived at. Provider meanwhile may consider treating him by taking a token deposit or as per their norms.
4.12 If pre-authorization is issued after ascertaining the coverage provider should refund the amount if taken barring a token amount to take care of non covered expenses. Post emergency patient must be transferred to the room which he is eligible for as per his health plan, which would be mentioned in the pre-authorization certificate.
Emergency Admission. 9.3.1 In case of a vehicular accident, if the Driver is under the influence of alcohol or inebriating drugs, if detected or suspected, Provider will inform the same to MHCL, whenever and whatever is possible.
9.3.2 In case of other emergencies the provider should call up the help desk of MHCL for guarantee of payment. MHCL may continue to discuss with treating doctor till conclusion of eligibility of coverage is arrived at. Provider meanwhile may consider treating him as per their norms.
9.3.3 If Authorisation is issued after ascertaining the coverage provider should refund the amount if taken barring a token amount to take care of non covered expenses. Post emergency patient must be transferred to the room, which he is eligible for as per his health plan, which would be mentioned in the Authorisation certificate.
Emergency Admission. 2.1. The Parties agree that the Hospital shall admit the Beneficiary (ies) in the case of emergency but the smart card will need produced and authenticated within 24 hours of the admission.
2.2. Hospital upon deciding to admit the Beneficiary should inform/ intimate over phone immediately to the 24 hours Insurer’s helpdesk or the local/ nearest Insurer office.
2.3. The data regarding admission shall be sent electronically to the server of the insurance company
2.4. If the package selected for the beneficiary is already listed in the package list then no pre-authorisation will be needed from the Insurance Company.
2.5. If the treatment to be provided is not part of the package list then hospital will need to get the pre- authorisation from the Insurance Company as given in part 2 of Annexure 1.
2.6. On receipt of the preauthorization form for the hospital giving the details of the ailments for admission and the estimated treatment cost, which is to be forwarded within 12 hours of admission, Insurer undertakes to issue the confirmation letter for the admissible amount within 12 hours of the receipt of the preauthorization form subject to policy terms & conditions.
2.7. In case the ailment is not covered or given medical data is not sufficient for the medical team to confirm the eligibility, Insurer can deny the guarantee of payment, which shall be addressed, to the Insured under intimation to the Hospital. The hospital will have to follow their normal practice in such cases.
2.8. Denial of Authorization/ guarantee of payment in no way mean denial of treatment. The hospital shall deal with each case as per their normal rules and regulations.
2.9. Authorization certificate will mention the amount guaranteed class of admission, eligibility of beneficiary or various sub limits for rooms and board, surgical fees etc. wherever applicable. Hospital must take care to ensure compliance.
2.10. The guarantee of payment is given only for the necessary treatment cost of the ailment covered and mentioned in the request for hospitalization. Any investigation carried out at the request of the patient but not forming the necessary part of the treatment also must be collected from the patient.
0.00. Xx case the sum available is considerably less than the estimated treatment cost, Hospital should follow their normal norms of deposit/ running bills etc., to ensure that they realize any excess sum payable by the beneficiaries not provided for by indemnity.
Emergency Admission. Occasionally a person’s needs may be such that an admission without prior assessment is required (emergency admission). The admission will still require prior authorisation by the Service Purchaser who will authorise funding up to a maximum of seven days during which time an assessment will be conducted.
Emergency Admission. Admission upon request of a health or peace officer pursuant to Minn. Stat. 253B.05.
Emergency Admission. 4.1 In case of a vehicular accident, if the victim was under influence of alcohol or inebriating drugs. It is mandatory for the provider to inform the cause of emergency to NTT, Jalandhar in order to issue authorisation letter.
4.2 In case of other emergencies, the provider should call up the Admin authorities/Medical officer of NIT, Jalandhar for Authorisation NIT Jalandhar may continue to discuss the case with the treating doctor till conclusion of eligibility of coverage is arrived at. Provider in the meanwhile may consider treating the patient by taking a token deposit or as per their norms.
4.3 If AL is issued after ascertaining the coverage, provider should refund the amount if taken, barring a token amount to take care of non-covered expenses. Post emergency, patient must be transferred to the room, which he is eligible as mentioned in the authorisation letter.
Emergency Admission. One where the physician admits the Employee or his/her dependent to the hospital or treatment facility right after the sudden and, at the time, unexpected onset of a change in an
Emergency Admission. (a) In emergency, patient shall be admitted and life & limb saving treatment be given on production of ECHS card by the members, even in the absence of referral form. The treatment should not be delayed even if the ECHS beneficiary is not in possession of the ECHS card which can be brought later. All emergencies will be treated on cashless basis till stabilization even if the specialty concerned for management of the case is not empanelled. The hospital will inform the nearest Polyclinic / Online about such emergency admission within 48 hours. Payments will NOT be recovered from ECHS patient in such cases. The following ailments may be treated as an emergency which is illustrative only and not exhaustive, depending on the condition of the patient:-
(i) Acute Cardiac Conditions/Syndromes including Myocardial Infarction, Unstable Angina, Ventricular Arrhythmias, Paroxysmal Supraventricular Tachycardia, Cardiac Tamponade. Acute Left Ventricular Failure/Severe Congestive Cardiac Failure. Accelerated hypertension, complete dissection of Aorta etc.
(ii) Vascular Catastrophies including Acute limb ischemia, Rupture of aneurysm, medical and surgical shock and peripheral circulatory failure.
(iii) Cerebro-Vascular Accidents including strokes, neurological emergencies including coma, cerbro-meningeal infections, convulsions, acute paralysis, acute visual loss.
(iv) Acute Respiratory Emergencies including Respiratory failure and decompensated lung disease.
(v) Acute abdomen including acute obstetrical and gynecological emergencies.
(vi) Life threatening injuries including Road traffic accidents, Head injuries, Multiple Injuries, Crush Injuries and thermal injuries etc etc.
(vii) Acute poisonings and snake bite. (viii) Acute endocrine emergencies including Diabetic Ketoacidosis.
