GUIDELINES FOR REIMBURSABLE MEDICAL SERVICES Sample Clauses

GUIDELINES FOR REIMBURSABLE MEDICAL SERVICES. Medical Services reimbursable through the MSN Program means those services that are 3 medically necessary to protect life, prevent significant disability, or prevent serious deterioration of
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GUIDELINES FOR REIMBURSABLE MEDICAL SERVICES. 12 A. Medical Services reimbursable through the MSN Program means those services that are 13 medically necessary to protect life, prevent significant disability, or prevent serious deterioration of 14 health. Reimbursable and non-reimbursable services include those covered in the MSN Provider 15 Manual as approved by the Medical Policy Committee (MPC). The scope of Medical Services to be 16 provided by CONTRACTOR may include, but are not limited to: diagnostic and therapeutic services 17 and emergent or urgent dental services. 18 B. Follow-Up Care and Specialty Services 19
GUIDELINES FOR REIMBURSABLE MEDICAL SERVICES. 16 Three, unless additional funding is made available through COUNTY’s agreement with Intermediary. 17 18 20 24 1. Throughout the term of the Agreement, the MSN Funding
GUIDELINES FOR REIMBURSABLE MEDICAL SERVICES. 25 A. Medical Services reimbursable through the MSN Program means those services that are 26 medically necessary to protect life, prevent significant disability, or prevent serious deterioration of 27 health. Reimbursable and non-reimbursable services include those covered in the MSN Provider 28 Manual as approved by the Medical Policy Committee (MPC). The scope of Medical Services to be 29 provided by CONTRACTOR may include, but are not limited to: , diagnostic and therapeutic services 30 and emergent or urgent dental services. 31 B. Follow-Up Care and Specialty Services - CONTRACTOR shall provide medically necessary 32 follow-up care, as appropriate, to MSN enrollees, which may include, but is not limited to, the
GUIDELINES FOR REIMBURSABLE MEDICAL SERVICES. 8 A. Medical Services reimbursable through the MSN Program means those services that are 12 B. The scope of Medical Services to be provided by CONTRACTOR may include, but are not 14 1. Acute hospital inpatient services, including room and board, diagnostic and therapeutic 17 a. Emergency Services including ancillary services, laboratory, therapy services, 19 b. Outpatient Hospital Services including hospital based surgical center services, ancillary 22 c. Blood and blood derivatives. 23 d. Prosthetic and medical supplies. 24

Related to GUIDELINES FOR REIMBURSABLE MEDICAL SERVICES

  • Medical Services Plan Regular Full-Time and Temporary Full-Time Employees shall be entitled to be covered under the Medical Services Plan commencing the first day of the calendar month following the date of employment. The City shall pay one hundred percent (100%) of the premiums required by the plan.

  • Professional Services Fees You agree to pay us the professional services fees in the amounts set forth in the Investment Summary. Those amounts are payable in accordance with our Invoicing and Payment Policy. You acknowledge that the fees stated in the Investment Summary are good-faith estimates of the amount of time and materials required for your implementation. We will bill you the actual fees incurred based on the in-scope services provided to you. Any discrepancies in the total values set forth in the Investment Summary will be resolved by multiplying the applicable hourly rate by the quoted hours.

  • Educational Services Any service or supply for education, training or retraining services or testing including: special education, remedial education; cognitive remediation; wilderness/outdoor treatment, therapy or adventure programs (whether or not the program is part of a Residential Treatment facility or otherwise licensed institution); job training or job hardening programs; educational services and schooling or any such related or similar program including therapeutic programs within a school setting.

  • 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.

  • Medical Services We do not Cover medical services or dental services that are medical in nature, including any Hospital charges or prescription drug charges.

  • Outpatient Services Physicians, Urgent Care Centers and other Outpatient Providers located outside the BlueCard® service area will typically require You to pay in full at the time of service. You must submit a Claim to obtain reimbursement for Covered Services.

  • 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.

  • Inpatient Services Hospital Rehabilitation Facility

  • Technical Services Party B will provide technical services and training to Party A, taking advantage of Party B’s advanced network, website and multimedia technologies to improve Party A’s system integration. Such technical services shall include: (a) administering, managing and maintaining Party A’s information application system and website system infrastructure; (b) providing system optimization plans and implementing optimization features; (c) assuring the security and reliability of the website application systems; (d) procuring, installing and supporting the relevant products produced by Party B, and providing training in the use of those products; (e) managing and maintaining all network and providing technologies to assure the reliability and efficiency thereof; (f) providing information technology services and assuring the reliable operation of the information infrastructure.

  • Required Services Consultant agrees to perform the services, and deliver to City the “Deliverables” (if any) described in the attached Exhibit A, incorporated into the Agreement by this reference, within the time frames set forth therein, time being of the essence for this Agreement. The services and/or Deliverables described in Exhibit A shall be referred to herein as the “Required Services.”

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