Intensive Care. Xx. Xxxxx-
Intensive Care. Cardiac care unit or other unit or area of a Hospital that meets the required standards of the Joint Commission on Accreditation of Hospitals for Special Care Units. Intoxicated: A blood alcohol level which equals or exceeds the legal limit for operating a motor vehicle in the state or jurisdiction where you are located at the time of an incident. Master Policy of Insurance: That certain group insurance policy No. RCB07421 issued to World Commercial Trust by Certain Underwriters at Lloyd’s, London, which is available upon request from the Administrator. Medical Emergency: Occurrence of a Sickness, Illness, Injury, or behavioral condition, the onset of which is sudden, that manifests itself by symptoms of sufficient severity, including severe pain that an individual could reasonably expect the absence of immediate medical attention to result in (i) placing the health of the person afflicted with such condition in serious jeopardy or, in the case of a behavioral condition, placing the health of such person or others in serious jeopardy; (ii) serious impairment to such person's bodily functions; (iii) serious dysfunction of any bodily organ or part of such person; or (iv) serious disfigurement of such person. Additionally, a Medical Emergency will include visits where the only option for necessary immediate care is an emergency room. Medically Necessary or Medical Necessity: Services and supplies received while insured that are determined by the Company to be (i) appropriate and necessary for the symptoms, diagnosis, or direct care and Treatment of Your medical conditions; (ii) within the standards the organized medical community deems good medical practice for Your condition; (iii) not primarily for the convenience of You, Your Physician, or another Service Provider or person; (iv) not Experimental/Investigational or unproven as recognized by the organized medical community or which are used for any type of research program or protocol; and (v) not excessive in scope, duration, or intensity to provide safe, adequate, and appropriate treatment. For Hospital stays, this means that acute care as an Inpatient is necessary due to the kinds of services You are receiving or the severity of Your condition in that safe and adequate care cannot be received as an Outpatient or in a less intensified medical setting. The fact that any particular Physician may prescribe, order, recommend, or approve a service, supply, or level of care does not, of itself, make such treatm...
Intensive Care. Unit Hospital unit required for patients with critical health conditions and who need life support of organic functions beside special medical supervision and constant monitoring. Intensive Outpatient Programs (IOP) Program that provides intensive treatment and support for the treatment of some conditions such as, depression and anxiety disorders, and substance dependence not requiring detoxification. Internal Appeal Request for revision of an adverse determination of benefits or of the result of the investigation of a complaint before the plan or insurer. Main Insured certificate with the insurance company. Maintenance Drugs Maintenance drugs are those whose most common use is treating chronic diseases. Therapy with this medication is not considered curative. Maintenance drugs are administered continuously (for over ninety (90) days) instead of intermittently. Marriage Marriage is a civil institution that originates with a civil contract in which the contracting parties mutually agree to become spouses and follow the duties imposed by the law, as applicable, in the United States and its territories. It is valid only when it is contracted and solemnized according to the provisions of law, and may be dissolved before the death of any of the spouses only in cases as expressly provided by law. Maximum Out-of- Pocket or MOOP Maximum amount of money that an insured has to pay during a period of benefits in addition to the premium before the insurance company pays one- hundred percent (100%) of the services covered under this certificate. MCS Life Clinical Affairs MCS Life department that groups the following units: Pre-authorization, Hospital Review, Education and Wellbeing, Managed Care and Care Transition. Medical Emergency Condition in which the symptoms presented are severe enough for a reasonable and prudent person with average health and medical knowledge to reasonably conclude that the absence of immediate medical care could result in: putting at risk the health of a person or the health of an unborn child, a serious impairment to body functions, or serious dysfunction of any body part or organ. Medical necessity Care, service or supply generally accepted by the medical community as effective, appropriate, and essential to diagnose and treat an illness or injury, and that: Is based on generally accepted or recognized standards of care and that are appropriate for the symptoms, diagnosis and treatment of an injury, condition or illness, and for direct car...
Intensive Care. General Renal Intensive Care – Neonatal Stomal Therapy Midwifery
