Hospitalization Services Sample Clauses
The Hospitalization Services clause defines the scope and terms under which medical care provided during a hospital stay is covered. It typically outlines which types of hospital admissions, treatments, and related expenses are included, such as room charges, surgical procedures, and nursing care, and may specify any exclusions or limitations. This clause ensures that both the provider and the patient understand what hospital-based services are eligible for coverage, thereby reducing disputes and clarifying financial responsibilities during inpatient care.
Hospitalization Services. 7.5.10.1 The Contractor shall make available through its Network Providers hospitalization services, including the following:
7.5.10.1.1 Nursery;
7.5.10.1.2 Semi-private room (bed available 24 hours a day, every day of the year);
7.5.10.1.3 Isolation room for medical reasons;
7.5.10.1.4 Food, including specialized nutrition services;
7.5.10.1.5 Regular nursing services;
7.5.10.1.6 Specialized room use, such as operation, surgical, recovery, treatment and maternity without limitations;
7.5.10.1.7 Drugs, medicine and contrast agents, without limitations;
7.5.10.1.8 Materials such as bandages, gauze, plaster or any other therapeutic or healing material;
7.5.10.1.9 Therapeutic and maintenance care services, including the use of the necessary equipment to offer the service;
7.5.10.1.10 Specialized diagnostic tests, such as electrocardiograms, electroencephalograms, arterial gases and other specialized tests that are available at the hospital and necessary during Enrollee's hospitalization;
7.5.10.1.11 Supply of oxygen, anesthetics and other gases including administration;
7.5.10.1.12 Respiratory therapy, without limitations;
7.5.10.1.13 Rehabilitation services while patient is hospitalized, including physical, occupational and speech therapy;
7.5.10.1.14 Outpatient surgery facility use; and
7.5.10.1.15 Blood and blood plasma, without limitations, including
7.5.10.1.15.1 authologal and irradiated blood;
7.5.10.1.15.2 monoclonal factor IX with a certified hematologist Referral;
7.5.10.1.15.3 intermediate purity concentrated ant hemophilic factor (Factor VIII);
7.5.10.1.15.4 monoclonal type antihemophilic factor with a certified hematologist’s authorization; and
7.5.10.1.15.5 activated protrombine complex (Autoflex and Feiba) with a certified hematologist’s authorization.
7.5.10.2 Hospitalization for services that would normally be considered outpatient services, or for diagnostic purposes only, is not a Covered Service under MiSalud.
Hospitalization Services. 7.5.10.1 The Contractor shall provide hospitalization serVIces, including the following:
Hospitalization Services. The Contractor shall provide hospitalization services, including the following: Access to a nursery; Access to a semi-private room (bed available twenty-four
Hospitalization Services. 7.5.10.1 The Contractor shall make available through its Network Providers hospitalization services, including the following:
7.5.10.1.1 Nursery;
7.5.10.1.2 Semi-private room (bed available 24 hours a day, every day of the year);
7.5.10.1.3 Isolation room for medical reasons;
7.5.10.1.4 Food, including specialized nutrition services;
7.5.10.1.5 Regular nursing services;
7.5.10.1.6 Specialized room use, such as operation, surgical, recovery, treatment and maternity without limitations;
7.5.10.1.7 Drugs, medicine and contrast agents, without limitations;
7.5.10.1.8 Materials such as bandages, gauze, plaster or any other therapeutic or healing material;
7.5.10.1.9 Therapeutic and maintenance care services, including the use of the necessary equipment to offer the service;
7.5.10.1.10 Specialized diagnostic tests, such as electrocardiograms, electroencephalograms, arterial gases and other specialized tests that are available at the hospital and necessary during Enrollee's hospitalization;
7.5.10.1.11 Supply of oxygen, anesthetics and other gases including administration;
7.5.10.1. 12 Respiratory therapy, without limitations;
Hospitalization Services. 7.5.10.1 The Contractor shall provide hospitalization services, including the following:
7.5.10.1.1 Access to a nursery;
7.5.10.1. 2 Access to a semi-private room (bed available twenty-four (24) hours a day, every Calendar Day of the year, including Puerto Rico holidays);
7.5.10.1. 3 Access to an isolation room for physical or Behavioral Health reasons;