Emergency Ambulance Services Sample Clauses

Emergency Ambulance Services. The HMO may require submission of a trip ticket with ambulance claims before paying the claim. Claims submitted without a trip ticket need only be paid at the service charge rate. The HMO must: a. Pay a service fee for an ambulance response to a call in order to determine whether an emergency exists, regardless of the HMO’s determination to pay for the call. b. Pay for emergency ambulance services based on established BadgerCare Plus and/or Medicaid SSI criteria for claims payment of these services. c. Either pay or deny payment of a clean claim from an ambulance service within 45 days of receipt of the clean claim. d. Respond to appeals from ambulance providers within the time frame described. Failure will constitute the HMO’s agreement to pay the appealed claim to the extent FFS Medicaid would pay.
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Emergency Ambulance Services. The PIHP may require submission of a trip ticket with ambulance claims before paying the claim. Claims submitted without a trip ticket need only be paid at the service charge rate. The PIHP must: a. Pay a service fee for an ambulance response to a call in order to determine whether an emergency exists, regardless of the PIHP’s determination to pay for the call. b. Pay for emergency ambulance services based on established Medicaid criteria for claims payment of these services. c. Either pay or deny payment of a clean claim from an ambulance service within 45 days of receipt of the clean claim. d. Respond to appeals from ambulance providers within the time frame described. Failure will constitute the PIHP’s agreement to pay the appealed claim in full.
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Emergency Ambulance Services. Network Commercial ambulance charges for transportation to the nearest hospital where emergency care can be performed are not subject to deductible or coinsurance. Medically necessary emergency ambulance services will be subject to a $15 copayment.
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Emergency Ambulance Services. Allowed Amounts for ground and Air Ambulance transport provided by an out-of- Network provider will be determined as described below under Allowed Amounts in this Schedule of Benefits. Ground Ambulance: 40% Yes Yes Air Ambulance: 40% Yes Yes Non-Emergency Ambulance Transportation Ground or Air Ambulance, as we determine appropriate. Ground Ambulance: 40% Yes Yes Allowed Amounts for Air Ambulance transport provided by an out-of- Network provider will be determined as described below under Allowed Amounts in this Schedule of Benefits. Air Ambulance: 40% Yes Yes Depending upon the Covered Health Care Service, Benefit limits are the same as those stated under the specific Benefit category in this Schedule of Benefits. Depending upon where the Covered Health Care Service is provided, Benefits will be the same as those stated under each Covered Health Care Service category in this Schedule of Benefits. Dental Anesthesia 40% Yes Yes Amounts which you are required to pay as shown below in the Schedule of Benefits are based on Allowed Amounts or, for specific Covered Health Care Services as described in the definition of Recognized Amount in the Policy, Recognized Amounts. The Allowed Amounts provision near the end of this Schedule of Benefits will tell you when you are responsible for amounts that exceed the Allowed Amount.
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Emergency Ambulance Services. Allowed Amounts for ground and Air Ambulance transport provided by an out-of- Network provider will be determined as described below under Allowed Amounts in this Schedule of Benefits. Ground Ambulance: 40% Yes Yes Air Ambulance: 40% Yes Yes Non-Emergency Ambulance Transportation Ground or Air Ambulance, as we determine appropriate. Ground Ambulance: 40% Yes Yes Allowed Amounts for Air Ambulance transport provided by an out-of- Network provider will be determined as described below under Allowed Air Ambulance: 40% Yes Yes Amounts which you are required to pay as shown below in the Schedule of Benefits are based on Allowed Amounts or, for specific Covered Health Care Services as described in the definition of Recognized Amount in the Policy, Recognized Amounts. The Allowed Amounts provision near the end of this Schedule of Benefits will tell you when you are responsible for amounts that exceed the Allowed Amount.
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Emergency Ambulance Services. For transportation to the nearest Hospital which can provide such emergency care only if a responsible person would have believed that the medical condition was an emergency medical condition which required ambulance services. $50 / Trip
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Emergency Ambulance Services. GRANTEE employment of at least six (6) FTE ambulance paramedics, for staffing at least two (2) licensed/certified paramedics for emergency ambulance response twenty-four (24) hours each day of the fiscal year. This includes all roll-up costs and certification expenses, as outlined within the original grant application dated 4/27/2021. FY2022-23 $366,654.00 TOTAL $366,654.00 // In accordance with the terms of this Agreement, the DISTRICT shall disburse the following payment(s) to the GRANTEE: DATE PURPOSE AMOUNT 1 Within 30 days after grant agreement is fully signed. Quarterly lump sum payment for qualifying items specified within EXHIBIT A. Alternatively, during the term of this Agreement, GRANTEE may elect to pay for said items and then subsequently request reimbursement, in writing, within 180 days after paying for said items. Up to $91,663.50 2 On or after 10/15/2022 Quarterly lump sum payment for qualifying items specified within EXHIBIT A. Alternatively, during the term of this Agreement, GRANTEE may elect to pay for said items and then subsequently request reimbursement, in writing, within 180 days after paying for said items. Up to $91,663.50 3 On or after 1/15/2023 Quarterly lump sum payment for qualifying items specified within EXHIBIT A. Alternatively, during the term of this Agreement, GRANTEE may elect to pay for said items and then subsequently request reimbursement, in writing, within 180 days after paying for said items. Up to $91,663.50 4 On or after 4/15/2023 Quarterly lump sum payment for qualifying items specified within EXHIBIT A. Alternatively, during the term of this Agreement, GRANTEE may elect to pay for said items and then subsequently request reimbursement, in writing, within 180 days after paying for said items. Up to $91,663.50 Use and disbursal of Grant Funds is contingent upon GRANTEE using its best efforts at recruiting, hiring and retaining at least six (6) FTE paramedics which are appropriately licensed/certified, subject to normal and unanticipated vacancies, and GRANTEE’s quarterly written accounting and verification to DISTRICT of all offsetting GRANTEE revenues for services rendered with personnel funded by the Grant Funds. XXXXXXX’s quarterly written reports must report the number of capture service calls which exceed FY2020-21 levels and compare revenues received by GRANTEE due to increased staff funded by DISTRICT. GRANTEE must match each DISTRICT dollar utilized from the Grant Funds and any unencumbered Grant Funds ...
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Emergency Ambulance Services. Medically Necessary hospital to hospital transfers and emergency ambulance transportation by a licensed ambulance service (either ground or air ambulance) to or from the nearest hospital where Emergency Services can be provided.
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Emergency Ambulance Services. The Host shall provide emergency medical services on an as requested basis. UDLP will reimburse the Host for direct labor and material costs.
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Related to Emergency Ambulance Services

  • Ambulance Services Ground Ambulance Air and Water Ambulance

  • Hospice Services Services are available for a Member whose Attending Physician has determined the Member's illness will result in a remaining life span of six months or less.

  • Surgery Services This plan covers surgery services to treat a disease or injury when: • the operation is not experimental or investigational, or cosmetic in nature; • the operation is being performed at the appropriate place of service; and • the physician is licensed to perform the surgery. This plan covers reconstructive surgery and procedures when the services are performed to relieve pain, or to correct or improve bodily function that is impaired as a result of: • a birth defect; • an accidental injury; • a disease; or • a previous covered surgical procedure. Functional indications for surgical correction do not include psychological, psychiatric or emotional reasons. This plan covers the procedures listed below to treat functional impairments. • abdominal wall surgery including panniculectomy (other than an abdominoplasty); • blepharoplasty and ptosis repair; • gastric bypass or gastric banding; • nasal reconstruction and septorhinoplasty; • orthognathic surgery including mandibular and maxillary osteotomy; • reduction mammoplasty; • removal of breast implants; • removal or treatment of proliferative vascular lesions and hemangiomas; • treatment of varicose veins; or • gynecomastia.

  • Transportation Services i) In the event that transportation services for a student served by CONTRACTOR pursuant to an Individual Services Agreement are to be provided by a party other than CONTRACTOR or the LEA or its transportation providers, such services shall be reflected in a separate agreement signed by the parties hereto, and provided to the LEA and SELPA Director by the CONTRACTOR. Except as provided below, CONTRACTOR shall compensate the transportation provider directly for such services, and shall charge the LEA for such services at the actual and reasonable rates billed by the transportation provider, plus a ten percent (.

  • Disaster Services In the event of a local, state, or federal emergency, including natural, man-made, criminal, terrorist, and/or bioterrorism events, declared as a state disaster by the Governor, or a federal disaster declared by the appropriate federal official, Grantee may be called upon to assist the System Agency in providing the following services: i. Community evacuation; ii. Health and medical assistance; iii. Assessment of health and medical needs; iv. Health surveillance; v. Medical care personnel; vi. Health and medical equipment and supplies; vii. Patient evacuation; viii. In-hospital care and hospital facility status; ix. Food, drug and medical device safety; x. Worker health and safety; xi. Mental health and substance abuse; xii. Public health information; xiii. Vector control and veterinary services; and xiv. Victim identification and mortuary services.

  • Emergency Services The parties recognize that in the event of a strike or lockout, situations may arise of an emergency nature. To this end, the Employer and the Union will agree to provide services of an emergency nature.

  • Maintenance Services Subject to Client’s timely payment of the applicable maintenance fees, Accenture will make available the following maintenance services (“Maintenance Services”):

  • Special Services Should the Trust have occasion to request the Adviser to perform services not herein contemplated or to request the Adviser to arrange for the services of others, the Adviser will act for the Trust on behalf of the Fund upon request to the best of its ability, with compensation for the Adviser's services to be agreed upon with respect to each such occasion as it arises.

  • Pharmacy Services The Contractor shall establish a network of pharmacies. The Contractor or its PBM must provide at least two (2) pharmacy providers within thirty (30) miles or thirty (30) minutes from a member’s residence in each county, as well as at least two (2) durable medical equipment providers in each county or contiguous county.

  • Administration Services When a medical prescription drug is administered by infusion, the administration of the prescription drug may be covered separately from the prescription drug. See Infusion Therapy - Administration Services in the Summary of Medical Benefits for benefit limits and the amount you pay. Prescription drugs that are self-administered are not covered as a medical benefit but may be covered as a pharmacy benefit. Please see Pharmacy Prescription Drugs and Diabetic Equipment or Supplies – Pharmacy Benefits section above for additional information. For some medical prescription drugs, after the first administration, coverage may be limited to certain locations (for example, a designated outpatient or ambulatory service facility, physician’s office, or your home), provided the location is appropriate based on your medical status. For a list of medical prescription drugs that are subject to this Site of Care Program, visit our website. Preauthorization may be required to determine medical necessity as well as appropriate site of care. If we deny your request for preauthorization, or you disagree with our determination for the appropriate site of care, you can submit a medical appeal. See Appeals in Section 5 for information on how to file a medical appeal.

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