Common use of Mandatory Second Surgical Opinion Clause in Contracts

Mandatory Second Surgical Opinion. For all inpatient and outpatient, non-emergency surgeries, a second surgical opinion may be required as directed by the Medical Utilization Review Administrator. This second opinion shall be covered at one hundred percent (100%) of reasonable charges. If the first two opinions conflict, a third opinion shall also be covered at one hundred percent (100%) of reasonable charges. If a second opinion is not obtained for the surgeries, a ten percent (10%) penalty of total charges shall be applied, in addition to the deductible, coinsurance and out- of-pocket maximum provisions.

Mandatory Second Surgical Opinion. For all inpatient and outpatient, non-non- emergency surgeries, a second surgical opinion may be required as directed by the Medical Utilization Review Administrator. This second opinion shall be covered at one hundred percent (100%) of reasonable charges. If the first two opinions conflict, a third opinion shall also be covered at one hundred percent (100%) of reasonable charges. If a second opinion is not obtained for the surgeries, a ten percent (10%) penalty of total charges shall be applied, in addition to the deductible, coinsurance and out- out-of-pocket maximum provisions.

Mandatory Second Surgical Opinion. For all inpatient and outpatient, non-emergency surgeries, a second surgical opinion may be required as directed by the Medical Utilization Review Administrator. This second opinion shall be covered at one hundred percent (100%) of reasonable charges. If the first two opinions conflict, a third opinion shall also be covered at one hundred percent (100%) of reasonable charges. If a second opinion is not obtained for the surgeries, a ten percent (10%) penalty of total charges shall be applied, in addition to the deductible, coinsurance and out- out-of-pocket maximum provisions.