Medical Case Management Sample Clauses

Medical Case Management. This program allows a consultant to review a patient's medical treatment plan to determine whether the covered person qualifies for alternate medical care. The determination of eligibility for a patient's medical case management will be primarily based upon medical necessity and appropriate medical care. Recommendations will be made to the family and health care providers; however, the decision to receive alternate medical care rests with the employee and the physician. The Medical Utilization Review Administrator will recommend alternate medical treatment on a case-by-case basis. Alternate medical treatment benefits refer to expenses that are approved before they are incurred, which may not otherwise be payable as covered expenses under the medical plan.

Medical Case Management. A program that allows a consultant to review the medical treatment for an individual to determine whether the covered person does or does not qualify for alternate medical treatment benefits. The determination for a patient's medical case management eligibility will be primarily based upon medical necessity and appropriate medical care. The Plan Administrator will recommend alternate medical treatment on a case-by-case basis. Alternate medical treatment benefits refer to expenses that are approved before they are incurred, which may not otherwise be payable as covered expenses under the medical plan.

Medical Case Management. The Town or its designed occupational health consultant will review all requests for indemnification of medical expenses and will make payment for indemnification of medical expenses and will make payment for reasonable and customary charges.

Medical Case Management. The Town or its designated occupational health consultant will review all requests for indemnification of medical expenses and will make payment for reasonable charges. Injured employees will be required to provide medical information release forms from all relevant medical providers for injuries/illnesses for which benefits are sought. It is understood that all employee medical information will be kept strictly confidential as provided by law.

Medical Case Management. On-site Medical Management, Medical Bill Repricing and Vocational Rehabilitation.

Medical Case Management. Contractor shall use XStremeMD for medical case management following an occupational injury or illness event. Note: Contractor may elect to use its own case management provider if pre-approved by Company.

Medical Case Management. 1.7.1 Contractor shall refer for medical case management all claims which meet agreed upon medical criteria. The criteria for case referrals shall be incorporated in the Client Service Instructions as amended from time to time during the life of this agreement, which is attached and incorporated by reference as if fully set forth herein. 1.7.2 Contractor shall ensure that regular hospital and vendor utilization reviews are performed for all cases under Contractor's administration. Parameters for these reviews shall be incorporated in the Client Service Instructions which are attached hereto and incorporated by reference as if fully set forth herein.