Common use of Emergency Room Benefits Clause in Contracts

Emergency Room Benefits. Benefits are provided for Emergency Services provided in the emergency room of a Hospital. For the lowest out-of-pocket expenses, covered non- Emergency Services and emergency room follow- up services (e.g., suture removal, wound check, etc.) should be received in a Participating Physician’s office. Emergency Services are services provided for an unexpected medical condition, including a psychiatric emergency medical condition, manifesting itself by acute symptoms of sufficient severity (including severe pain) such that the absence of immediate medical attention could reasonably be expected to result in any of the following: (1) placing the Member’s health in serious jeopardy; (2) serious impairment to bodily functions; (3) serious dysfunction of any bodily organ or part.

Emergency Room Benefits. Benefits are provided for Emergency Services provided in the emergency room of a Hospital. For the lowest out-of-of- pocket expenses, covered non- non-Emergency Services and emergency room follow- follow-up services (e.g., suture removal, wound check, etc.) should be received in a Participating Physician’s office. Emergency Services are services provided for an unexpected medical condition, including a psychiatric emergency medical condition, manifesting itself by acute symptoms of sufficient severity (including severe pain) such that the absence of immediate medical attention could reasonably be expected to result in any of the following: (1) placing the Member’s health in serious jeopardy; (2) serious impairment to bodily functions; (3) serious dysfunction of any bodily organ or part.

Emergency Room Benefits. Benefits are provided for Emergency Services provided in the emergency room of a Hospital. For the lowest out-of-pocket expenses, covered non- non-Emergency Services and emergency room follow- follow-up services (e.g., suture removal, wound check, etc.) should be received in a Participating Physician’s office. Emergency Services are services provided for an unexpected medical condition, including a psychiatric emergency medical condition, manifesting itself by acute symptoms of sufficient severity (including severe pain) such that the absence of immediate medical attention could reasonably be expected to result in any of the following: (1) placing the Member’s health in serious jeopardy; (2) serious impairment to bodily functions; (3) serious dysfunction of any bodily organ or part.