Inpatient Hospital Claims Sample Clauses

Inpatient Hospital Claims. Claims for Inpatient Hospital services arranged through the BlueCard Worldwide Service Center require Members to pay only the usual Cost-Sharing Amounts. The Hospital files the claim for the Member. Members who receive Inpatient Hospital care from a Non-Participating Hospital or services that were not coordinated through the BlueCard Worldwide Service Center may have to pay the Hospital and submit the claim to the BlueCard Worldwide Service Center at X.X. Xxx 000000, Xxxxx, XX 00000. For all outpatient and professional medical care, the Member pays the Provider and then submits the claim to the BlueCard Worldwide Service Center at X.X. Xxx 000000, Xxxxx, XX 00000. The claim should be submitted showing the currency used to pay for the services. There is a specific claim form that must be used to submit international claims. Itemized bills must be submitted with the claim form. The international claim form can be accessed at xxxxxxxxxxxx.xxx. All claims must be submitted within twelve (12) months from the date of service with the exception of claims from certain State and Federal agencies.
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Inpatient Hospital Claims. Claims for Inpatient Hospital services arranged through the BlueCard Worldwide Service Center require Members to pay only the usual Cost-Sharing Amounts. The Hospital files the claim for the Member. Members who receive Inpatient Hospital care from a Non-Participating Hospital or services that were not coordinated through the BlueCard Worldwide Service Center may have to pay the Hospital and submit the claim to the BlueCard Worldwide Service Center at P.O. Box 261630, Miami, FL 33126. For all outpatient and professional medical care, the Member pays the Provider and then submits the claim to the BlueCard Worldwide Service Center at P.O. Box 261630, Miami, FL 33126. The claim should be submitted showing the currency used to pay for the services. There is a specific claim form that must be used to submit international claims. Itemized bills must be submitted with the claim form. The international claim form can be accessed at xxxxxxxxxxxx.xxx. All claims must be submitted within twelve (12) months from the date of service with the exception of claims from certain State and Federal agencies.
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Related to Inpatient Hospital Claims

  • Non-Medical, Personalized Services The Practice shall also provide Members with the following non-medical services:

  • Inpatient If you are an inpatient in a general or specialty hospital for mental health services, this agreement covers medically necessary hospital services and the services of an attending physician for the number of hospital days shown in the Summary of Medical Benefits. See Section

  • Health Care Operations “Health Care Operations” shall have the same meaning as the term “health care operations” in 45 CFR §164.501.

  • Hospital This plan covers behavioral health services if you are inpatient at a general or specialty hospital. See Inpatient Services in Section 3 for additional information. This plan covers services at behavioral health residential treatment facilities, which provide: • clinical treatment; • medication evaluation management; and • 24-hour on site availability of health professional staff, as required by licensing regulations. This plan covers intermediate care services, which are facility-based programs that are: • more intensive than traditional outpatient services; • less intensive than 24-hour inpatient hospital or residential treatment facility services; and • used as a step down from a higher level of care; or • used a step-up from standard care level of care. Intermediate care services include the following: • Partial Hospital Program (PHP) – PHPs are structured and medically supervised day, evening, or nighttime treatment programs providing individualized treatment plans. A PHP typically runs for five hours a day, five days per week. • Intensive Outpatient Program (IOP) – An IOP provides substantial clinical support for patients who are either in transition from a higher level of care or at risk for admission to a higher level of care. An IOP typically runs for three hours per day, three days per week.

  • Hospital Services The Hospital will: 6.1.1 achieve the Performance Standards described in the Schedules and the HSAA Indicator Technical Specifications; 6.1.2 not reduce, stop, start, expand, cease to provide or transfer the provision of Hospital Services to another hospital or to another site of the Hospital if such action would result in the Hospital being unable to achieve the Performance Standards described in the Schedules and the HSAA Indicator Technical Specifications; and 6.1.3 not restrict or refuse the provision of Hospital Services that are funded by the Funder to an individual, directly or indirectly, based on the geographic area in which the person resides in Ontario, and will establish a policy prohibiting any health care professional providing services at the Hospital, including physicians, from doing the same.

  • Extended Health Care Plan ‌ The Employer shall pay the monthly premium for regular employees entitled to coverage under a mutually acceptable extended health care plan.

  • Outpatient If you receive infusion therapy services in a hospital's outpatient unit, we cover the use of the treatment room, related supplies, and solutions. For prescription drug coverage, see Section 3.27

  • Extended Health Care Benefits The City will provide for all employees by contract through an insurer selected by the City an Extended Health Care Plan which will provide extended health care benefits. The City shall pay one hundred per cent (100%) of the premiums, which will include any premiums payable under The Health Insurance Act, R.S.O. 1990, as amended.

  • Radiation Therapy/Chemotherapy Services This plan covers chemotherapy and radiation services. This plan covers respiratory therapy services. When respiratory services are provided in your home, as part of a home care program, durable medical equipment, supplies, and oxygen are covered as a durable medical equipment service.

  • HEALTH CARE PLANS ‌ Notwithstanding the references to the Pacific Blue Cross Plans in this article, the parties agree that Employers, who are not currently providing benefits under the Pacific Blue Cross Plans may continue to provide the benefits through another carrier providing that the overall level of benefits is comparable to the level of benefits under the Pacific Blue Cross Plans.

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