HEALTH CARE MANAGEMENT SERVICES. a program which integrates all activity related to managing a Member’s medical care from the time that an admission, surgical or diagnostic procedure, or certain services become necessary. The program consists of any applicable pre-admission Certification, Admission Certification of Emergency Admissions, Outpatient Procedure or Covered Service Precertification, Continued Stay Review, Discharge Planning, and Individual Case Management.
Appears in 4 contracts
Samples: Individual Comprehensive Major Medical Preferred Provider Subscription Agreement, Individual Comprehensive Major Medical Preferred Provider Subscription Agreement, Individual Comprehensive Major Medical Preferred Provider Subscription Agreement
HEALTH CARE MANAGEMENT SERVICES. a program which integrates all activity related to managing a Member’s medical care from the time that an admission, surgical or diagnostic procedure, or certain services become necessary. The program consists of any applicable prePre-admission Certification, Admission Certification of Emergency Admissions, Outpatient Procedure or Covered Service Precertification, Continued Stay Review, Discharge Planning, and Individual Case Management.
Appears in 3 contracts
Samples: Individual Comprehensive Major Medical Preferred Provider Qualified High Deductible Health Plan Subscription Agreement, Individual Comprehensive Major Medical Preferred Provider Qualified High Deductible Health Plan Subscription Agreement, Individual Comprehensive Major Medical Preferred Provider Qualified High Deductible Health Plan Subscription Agreement
HEALTH CARE MANAGEMENT SERVICES. a program which integrates all activity related to managing a Member’s medical care from the time that an admission, surgical or diagnostic procedure, or certain services become necessary. The program consists of any applicable pre-admission Certification, Admission Certification of Emergency Admissions, Outpatient Procedure or Covered Service Precertification, Continued Stay Review, Discharge Planning, and Individual Case Management.
Appears in 2 contracts
Samples: Individual Comprehensive Major Medical Exclusive Provider Subscription Agreement, Individual Comprehensive Major Medical Exclusive Provider Subscription Agreement
