Follow-up Care After Emergency Surgery Sample Clauses

Follow-up Care After Emergency Surgery. If CareFirst BlueChoice authorizes, directs, refers, or otherwise allows a Member to access a hospital emergency facility or other Urgent Care facility for a medical condition that meets the criteria for Emergency Services, as defined in the Agreement, and the Member requires emergency surgery: A. Coverage is provided for services rendered by the physician, surgeon, oral surgeon, periodontist, or podiatrist who performed the surgical procedure for follow-up care that is Medically Necessary, directly related to the condition for which the surgical procedure was performed, and provided in consultation with the Member’s Primary Care Physician; and SAMPLE B. The Member will be responsible for the same Copayment for each follow-up visit as would be required for a visit to a Contracting Physician for specialty care.
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Follow-up Care After Emergency Surgery. If the Plan authorizes, directs, refers, or otherwise allows a Member to access a hospital emergency facility for a medical condition that requires emergency surgery: 1. Coverage shall be provided for services provided by the physician, oral surgeon, periodontist, or podiatrist, who performed the surgical procedure, for follow-up care that is: a. Medically Necessary; b. Directly related to the condition for which the surgical procedure was performed; and c. Provided in consultation with the Member’s Primary Care Provider; and The Member will be responsible for the same copayment or coinsurance for each follow up visit as would be required for a visit to a Network Provider for corresponding type of care.
Sample 1
Follow-up Care After Emergency Surgery. If the Plan authorizes, directs, refers, or otherwise allows a Member to access a hospital emergency facility or other Urgent Care Facility for a medical condition that requires emergency surgery: A. Coverage shall be provided for services provided by the physician, oral surgeon, periodontist, or podiatrist, who performed the surgical procedure, for follow−up care that is: 1. Medically Necessary; 2. Directly related to the condition for which the surgical procedure was performed; and 3. Provided in consultation with the Member’s Primary Care Physician; and B. The Member will be responsible for the same copayment or coinsurance for each follow up visit as would be required for a visit to a Plan Physician for corresponding type of care.
Sample 1

Related to Follow-up Care After Emergency Surgery

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