Mammography Services Sample Clauses

Mammography Services. Billing for Non-Capitated Services shall be as follows:
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Mammography Services. This Agreement provides coverage for low-dose screening mammograms for determining the presence of breast cancer. This coverage makes available one baseline mammogram to persons age 35-39, one mammogram biennially to persons age 40-49, and one mammogram annually to persons age 50 and over. After July 1, 1992, coverage shall be available only for screening mammograms obtained on equipment designed specifically to perform low-dose mammography in imaging facilities that have met American College of Radiology accreditation standards for mammography. These scans are Covered. Additionally, medically necessary and clinically appropriate diagnostic breast examinations using diagnostic mammography, breast magnetic resonance imaging, or breast ultrasound that evaluates an abnormality seen or suspected from a screening examination for breast cancer; or detected by another means of examination and medically necessary and clinically appropriate supplemental breast examinations using breast magnetic resonance imaging or breast ultrasound that is used to screen for breast cancer when there is no abnormality seen or suspected; and based on personal or family medical history or additional factors that may increase the individual’s risk of breast cancer are covered Your plan includes coverage for PrEP medication, as appropriate for you, and essential PrEP- related services without cost sharing, the same as any other preventive drug or service. This means that you do not have to make a copayment, pay coinsurance, satisfy a deductible or pay out-of-pocket for any part of the benefits and services listed in this summary if you receive them from an in-network provider. You may be required to pay a copay, coinsurance, and/or a deductible if you receive PrEP medication or PrEP-related services from an out-of-network provider if the same benefit or service is available from an in-network provider. • At least one FDA-approved PrEP drug, with timely access to the PrEP drug that is medically appropriate for the enrollee, as needed • HIV testing • Hepatitis B and C testing • Creatinine testing and calculated estimated creatine clearance or glomerular filtration rate • Pregnancy testing for individuals with childbearing potential • Sexually transmitted infection screening and counseling‌ • Adherence counseling • Office visits associated with each preventive service listed above • Quarterly testing for HIV and STIs, and annually for renal functions, required to maintain a PrEP prescript...
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Mammography Services. This Section 3.6 is only applicable during the period January 1, 2001, through December 31, 2001. Medical Group shall receive *** for each screening and diagnostic mammography study performed above the 1987 PacifiCare wide baseline, specific to the PacifiCare commercial program, for such studies. (This baseline equals ninety (90) studies per one thousand (1,000) adult females per Year.)
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Mammography Services. This agreement provides coverage for low-dose screening mammograms for determining the presence of breast cancer. This coverage makes available one baseline mammogram to persons age 35-39, one mammogram biennially to persons age 40-49, and one mammogram annually to persons age 50 and over. After July 1, 1992, coverage shall be available only for screening mammograms obtained on equipment designed specifically to perform low-dose mammography in imaging facilities that have met American College of Radiology accreditation standards for mammography. These scans are covered. Additionally, medically necessary and clinically appropriate diagnostic breast examinations using diagnostic mammography, breast magnetic resonance imaging, or breast ultrasound that evaluates an abnormality seen or suspected from a screening examination for breast cancer; or detected by another means of examination and medically necessary and clinically appropriate supplemental breast examinations using breast magnetic resonance imaging or breast ultrasound that is used to screen for breast cancer when there is no abnormality seen or suspected; and based on personal or family medical history or additional factors that may increase the individual's risk of breast cancer are covered.
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Mammography Services. 4 CONTRACTOR will conduct on-site bilateral screening mammography exams 5 to participants of the SJVIA at various locations and over multiple days for Participating Entities as 6 mutually agreed upon between CONTRACTOR and Participating Entity. 7 8 CONTRACTOR may only schedule mammography services with a 9 Participating Entity after receiving written approval from the SJVIA Manager, SJVIA Assistant 10 Manager, or designee to ensure that the Participating Entity is able to schedule the minimum 11 number of required exams as set forth in Exhibit B. Such services should be scheduled by the 12 Participating Entity at least 45 days in advance of services unless mutually agreed upon by 13 Participating Entity and CONTRACTOR. Upon receiving SJVIA approval, CONTRACTOR shall 14 work directly with Participating Entity to schedule actual dates and locations of mammography 15 services. 16 17 CONTRACTOR shall provide a notice of privacy practices to each participant 18 before conducting the bilateral screening mammography exam. 19 20 The bilateral screening mammography exam shall result in a written report, 21 including interpretation, by the radiologist who performed the exam. The report shall be sent to the 22 participant’s designated physician within 5-7 working days after the day of service.
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Related to Mammography Services

  • Pharmacy Services The Contractor shall establish a network of pharmacies. The Contractor or its PBM must provide at least two (2) pharmacy providers within thirty (30) miles or thirty (30) minutes from a member’s residence in each county, as well as at least two (2) durable medical equipment providers in each county or contiguous county.

  • Anesthesia Services This plan covers general and local anesthesia services received from an anesthesiologist when the surgical procedure is a covered healthcare service. This plan covers office visits or office consultations with an anesthesiologist when provided prior to a scheduled covered surgical procedure.

  • Surgery Services This plan covers surgery services to treat a disease or injury when: • the operation is not experimental or investigational, or cosmetic in nature; • the operation is being performed at the appropriate place of service; and • the physician is licensed to perform the surgery. This plan covers reconstructive surgery and procedures when the services are performed to relieve pain, or to correct or improve bodily function that is impaired as a result of: • a birth defect; • an accidental injury; • a disease; or • a previous covered surgical procedure. Functional indications for surgical correction do not include psychological, psychiatric or emotional reasons. This plan covers the procedures listed below to treat functional impairments. • abdominal wall surgery including panniculectomy (other than an abdominoplasty); • blepharoplasty and ptosis repair; • gastric bypass or gastric banding; • nasal reconstruction and septorhinoplasty; • orthognathic surgery including mandibular and maxillary osteotomy; • reduction mammoplasty; • removal of breast implants; • removal or treatment of proliferative vascular lesions and hemangiomas; • treatment of varicose veins; or • gynecomastia.

  • Related Services Licensee shall be responsible for obtaining and installing all proper hardware and support software (including operating systems) and for proper installation and implementation of and training concerning the Licensed Software. In the event that Licensee retains Licensor to perform any services with respect to the Licensed Software (for example: installation, implementation, maintenance, consulting and/or training services), Licensee and Licensor agree that such services shall be subject to Licensor’s then current standard terms, conditions and rates for such services unless otherwise agreed in writing by Licensor.

  • Telemedicine Services This plan covers clinically appropriate telemedicine services when the service is provided via remote access through an on-line service or other interactive audio and video telecommunications system in accordance with R.I. General Law § 27-81-1. Clinically appropriate telemedicine services may be obtained from a network or non- network provider, and from our designated telemedicine service provider. When you seek telemedicine services from our designated telemedicine service provider, the amount you pay is listed in the Summary of Medical Benefits. When you receive a covered healthcare service from a network or non-network provider via remote access, the amount you pay depends on the covered healthcare service you receive, as indicated in the Summary of Medical Benefits. For information about telemedicine services, our designated telemedicine service provider, and how to access telemedicine services, please visit our website or contact our Customer Service Department.

  • Hospice Services Services are available for a Member whose Attending Physician has determined the Member's illness will result in a remaining life span of six months or less.

  • Cloud Services You will not intentionally (a) interfere with other customers’ access to, or use of, the Cloud Service, or with its security; (b) facilitate the attack or disruption of the Cloud Service, including a denial of service attack, unauthorized access, penetration testing, crawling, or distribution of malware (including viruses, trojan horses, worms, time bombs, spyware, adware, and cancelbots); (c) cause an unusual spike or increase in Your use of the Cloud Service that negatively impacts the Cloud Service’s operation; or (d) submit any information that is not contemplated in the applicable Documentation.

  • Laboratory Services Covered Services include prescribed diagnostic clinical and anatomic pathological laboratory services and materials when authorized by a Member's PCP and HPN’s Managed Care Program.

  • Marketing Services The Manager shall provide advice and assistance in the marketing of the Vessels, including the identification of potential customers, identification of Vessels available for charter opportunities and preparation of bids.

  • 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.

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