Non-emergency ambulance services Sample Clauses

Non-emergency ambulance services. Members who receive medically necessary advanced or basic life support non-emergency ambulance services from AMR shall pay nothing out of pocket, except as specified herein. “Medical necessity” for purposes of determining whether any emergency or non-emergency transport qualifies for the membership benefit shall be determined by AMR using the standards of the Medicare program, which are also used by many other insurance programs. AMR reserves the right to require a certificate of medical necessity from a qualified physician in determining medical necessity. Without limiting the foregoing, transports to doctors’ or dentists’ offices; or outpatient trips to or transfers to another medical facility for the patient’s family or physician’s convenience, are generally not considered medically neces- sary.
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Non-emergency ambulance services. Except as stated in the Covered Services section of this Agreement, the Plan does not provide Benefits for Ambulance usage when another type of transportation can be used without endangering the Member’s health. Any ambulance usage for the convenience of the Member, family or Provider is not a Covered Service. This exclusion includes, but is not limited to, trips to an office, clinic, morgue or funeral home. Coverage is not available for air ambulance transport from a Hospital capable of treating the patient because the patient and/or the patient’s family prefer a specific hospital or physician. Air ambulance services are not covered to transport to a facility or long-term dwelling that is not an acute care hospital, such as a nursing facility, physician’s office, or your home.
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Non-emergency ambulance services. Medically Nec- xxxxxx ambulance Services to transfer the Member from a non-Plan Hospital to a Plan Hospital or between Plan facilities when in connection with authorized confine- ment/admission and use of the ambulance is authorized. AMBULATORY SURGERY CENTER BENEFITS Benefits are provided for Ambulatory Surgery Center Bene- fits on an Outpatient facility basis at an Ambulatory Surgery Center. Note: Outpatient ambulatory surgery Services may also be obtained from a Hospital or an Ambulatory Surgery Center that is affiliated with a Hospital, and will be paid according to Hospital Benefits (Facility Services) in the Plan Benefits sec- tion. Benefits are provided for Medically Necessary Services in connection with Reconstructive Surgery when there is no other more appropriate covered surgical procedure, and with regards to appearance, when Reconstructive Surgery offers more than a minimal improvement in appearance. In accord- ance with the Women’s Health and Cancer Rights Act, surgi- cally implanted and other prosthetic devices (including pros- thetic bras) and Reconstructive Surgery is covered on either breast to restore and achieve symmetry incident to a mastec- tomy, and treatment of physical complications of a mastec- tomy, including lymphedemas. Surgery must be authorized as described herein. Benefits will be provided in accordance with guidelines established by the Plan and developed in con- junction with plastic and reconstructive surgeons. No benefits will be provided for the following surgeries or procedures unless for Reconstructive Surgery:
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Non-emergency ambulance services. Except as stated in the Covered Services sec tion of this Agreement, the Plan does not provide Benefits for Ambulance usage when another type of transportation can be used family or P rovider is not a Cove red Service. This exclusion includes, but is not limited to, trips to a n office, clinic, morgue or funeral home. Coverage is not available for air ambulance transport from a Hospital capable of treating the patient family prefer a specific hospital or physician. Air ambulance services are not covered to transport to a facility or long - term dwelling that is not an acute care hospital,
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Non-emergency ambulance services. Non-Emergency ambulance transportation by a licensed ambulance service (either ground or air ambulance), as determined to be medically appropriate, between facilities when the transport is any of the following:
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Non-emergency ambulance services. Members who receive medically necessary advanced or basic life support non- emergency ambulance services from AMR shall pay nothing out of pocket, except as specified herein (see “c” below).
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Related to Non-emergency ambulance services

  • Ambulance Services Ground Ambulance This plan covers local professional or municipal ground ambulance services when it is medically necessary to use these services, rather than any other form of transportation as required under R.I. General Law § 27-20-55. Examples include but are not limited to the following: • from a hospital to a home, a skilled nursing facility, or a rehabilitation facility after being discharged as an inpatient; • to the closest available hospital emergency room in an emergency situation; or • from a physician’s office to an emergency room. Our allowance for ground ambulance includes the services rendered by an emergency medical technician or paramedic, as well as any drugs, supplies and cardiac monitoring provided. Air and Water Ambulance This plan covers air and water ambulance services when: • the time needed to move a patient by land, or the instability of transportation by land, may threaten a patient’s condition or survival; or • if the proper equipment needed to treat the patient is not available from a ground ambulance. The patient must be transported to the nearest facility where the required services can be performed and the type of physician needed to treat the patient’s condition is available. Our allowance for the air or water ambulance includes the services rendered by an emergency medical technician or paramedic, as well as any drugs, supplies and cardiac monitoring provided.

  • Outpatient emergency and urgicenter services within the service area The emergency room copay applies to all outpatient emergency visits that do not result in hospital admission within twenty-four (24) hours. The urgicenter copay is the same as the primary care clinic office visit copay.

  • Emergency Medical Services The City’s Fire Department and MedStar (or other entity engaged by the City after the Effective Date) will provide emergency medical services.

  • 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.

  • Emergency and urgently needed care outside the service area Professional services of a physician, emergency room treatment, and inpatient hospital services are covered at eighty percent (80%) of the first two thousand dollars ($2,000) of the charges incurred per insurance year, and one-hundred percent (100%) thereafter. The maximum eligible out-of-pocket expense per individual per year for this benefit is four hundred dollars ($400). This benefit is not available when the member’s condition permits him or her to receive care within the network of the plan in which the individual is enrolled.

  • Disaster Services In the event of a local, state, or federal emergency, including natural, man- made, criminal, terrorist, and/or bioterrorism events, declared as a state disaster by the Governor, or a federal disaster by the appropriate federal official, Grantee may be called upon to assist the System Agency in providing the following services:

  • Emergency Childcare Employees may use vacation leave for childcare emergencies after the employee has exhausted all of their accrued compensatory time. Use of vacation leave and sick leave for emergency childcare is limited to a combined maximum of four (4) days per calendar year.

  • Emergency Room Services This plan covers services received in a hospital emergency room when needed to stabilize or initiate treatment in an emergency. If your condition needs immediate or urgent, but non-emergency care, contact your PCP or use an urgent care center. This plan covers bandages, crutches, canes, collars, and other supplies incidental to your treatment in the emergency room as part of our allowance for the emergency room services. Additional services provided in the emergency room such as radiology or physician consultations are covered separately from emergency room services and may require additional copayments. The amount you pay is based on the type of service being rendered. Follow-up care services, such as suture removal, fracture care or wound care, received at the emergency room will require an additional emergency room copayment. Follow- up care services can be obtained from your primary care provider or a specialist. See Dental Services in Section 3 for information regarding emergency dental care services.

  • AIN Selective Carrier Routing for Operator Services, Directory Assistance and Repair Centers 4.3.1 BellSouth will provide AIN Selective Carrier Routing at the request of <<customer_name>>. AIN Selective Carrier Routing will provide <<customer_name>> with the capability of routing operator calls, 0+ and 0- and 0+ NPA (LNPA) 555-1212 directory assistance, 1+411 directory assistance and 611 repair center calls to pre-selected destinations.

  • 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.

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