Osteoporosis. Benefits will be provided for qualified individuals for reimbursement for scientifically proven bone mass measurement (bone density testing) for the prevention, diagnosis and treatment of osteoporosis for Members meeting Alliant’s criteria. OUTPATIENT SERVICES Outpatient services include facility, ancillary, facility-use, and professional charges when received as an outpatient at a Hospital, Hospital freestanding facility, Retail Health Clinic, or other Provider as determined by Alliant. These facilities may include a non-hospital site or other Provider facility providing surgery, diagnostic, x-rays, laboratory services, therapy, or rehabilitation services. Certain procedures require Prior Authorization. In an effort to manage quality and cost for our members, Alliant reserves the right to establish Preferred Providers for certain services. To determine if a Preferred Provider exists, it is the responsibility of the member to verify the in-network status of a Provider. Members may verify network status by visiting our Find-A-Provider tool on XxxxxxxXxxxx.xxx or calling Customer Service at (000) 000-0000. See the Summary of Benefits and Coverage for any applicable Deductible, Coinsurance, Copayment and benefit limitation information. OUTPATIENT SURGERY Hospital outpatient department or Freestanding Ambulatory Facility charges are Covered Services as outlined in the Summary of Benefits and Coverage. In-network and out-of-network cost-sharing apply accordingly. Some procedures require Prior Authorization. OVARIAN CANCER SURVEILLANCE TESTS • Covered Services are provided for at risk women 35 years of age and older. At risk women are defined as: o having a family history: with one or more first or second-degree relatives with ovarian cancer; of clusters of women relatives with breast cancer; of nonpolyposis; colorectal cancer; or o testing positive for BRCA1 or BRCA2 mutations.
Osteoporosis. Benefits will be provided for qualified individuals for reimbursement for scientifically proven bone mass measurement (bone density testing) for the prevention, diagnosis and treatment of osteoporosis for Members meeting Alliant’s criteria. Other Covered Services Your Contract provides Covered Services when the following services are Medically Necessary: • Chemotherapy and radioisotope, radiation and nuclear medicine therapy • Diagnostic x-ray and laboratory procedures • Dressings, when provided by a covered Physician • Oxygen, blood and components, and administration • Use of operating and treatment rooms and equipment Outpatient Services See the Summary of Benefits and Coverage’s for any applicable Deductible, Coinsurance, Copayment, and benefit limitation information. Outpatient services include facility, ancillary, facility use, and professional charges when given as an outpatient at a Hospital, Hospital freestanding facility, Retail Health Clinic, or other Provider as determined by us. These facilities may include a non-Hospital site providing diagnostic and therapy services, surgery, or rehabilitation, or other Provider facility as determined by us. Outpatient Surgery Hospital outpatient department or Freestanding Ambulatory Facility charges are covered at regular Contract benefits as shown in the Summary of Benefits and Coverage’s. Some procedures require Prior Authorization or prior approval. Ovarian Cancer Surveillance Tests • Covered Services are provided for at risk women 35 years of age and older. At risk women are defined as:
Osteoporosis. Eligible health services include the diagnosis, treatment and management of osteoporosis by a physician. The services include Food and Drug Administration approved technologies, including bone mass measurement. Prosthetic devices Eligible health services include the initial provision and subsequent replacement of a prosthetic device that your physician orders and administers. But we cover it only if we approve the device in advance. Prosthetic device means: • A device that temporarily or permanently replaces all or part of an external body part lost or impaired as a result of illness or injury or congenital defects. Coverage includes: • Repairing or replacing the original device you outgrow or that is no longer appropriate because your physical condition changed • Replacements required by ordinary wear and tear or damage • Instruction and other services (such as attachment or insertion) so you can properly use the device Spinal manipulation Eligible health services include spinal manipulation to correct a muscular or skeletal problem, but only if your provider establishes or approves a treatment plan that details the treatment, and specifies frequency and duration. Vision care Pediatric vision care Routine vision exams Eligible health services include a routine vision exam provided by an ophthalmologist or optometrist. The exam will include refraction and glaucoma testing. Vision care services and supplies Eligible health services include: • Office visits to an ophthalmologist, optometrist or optician related to the fitting of prescription contact lenses • Eyeglass frames, prescription lenses or prescription contact lenses that are identified as preferred by a vision provider • Eyeglass frames, prescription lenses or prescription contact lenses that are not identified as preferred by a vision provider, (non-preferred) • Non-conventional prescription contact lenses that are required to correct visual acuity to 20/40 or better in the better eye and that correction cannot be obtained with conventional lenses • Aphakic prescription lenses prescribed after cataract surgery has been performed • Low vision services In any one calendar year, this benefit will cover either prescription lenses for eyeglass frames or prescription contact lenses, but not both. Adult vision care Routine vision exams Eligible health services include a routine vision exam provided by an ophthalmologist or optometrist. The exam will include refraction and glaucoma testing. Vision care ser...
Osteoporosis. Osteoporosis is a term derived from the Greek language and directly translated means porous bone, “osteo” meaning bone and “poros” meaning pore [50]. The terminology associated with OP was developed by German pathologists in the nineteenth century, initially to distinguish it from other conditions such as osteomalacia and osteitis fibrosa cystica [11]. In 1941, Xxxxxxxx et al defined OP pathologically ‘as a condition in which there is a lack of bone tissue, but that tissue which remains is fully calcified’ [51]. The current definition of OP originated with a Consensus Development Conference (CDC) in 1999 [52] and was given credibility by a World Health Organisation (WHO) Study Group in 1994 [53]. It defines OP as: ‘A progressive systemic skeletal disease characterised by low bone mass and micro- architectural deterioration of bone tissue, with a consequent increase in bone fragility and susceptibility to fracture’ [42].
Osteoporosis. Coverage is provided for the Medically Necessary diagnosis and treatment of osteoporosis for high-risk Members, including but not limited to Members who: are estrogen-deficient and are at clinical risk for osteoporosis; have vertebral abnormalities, are receiving long-term glucocorticoid (steroid) therapy, have primary hyperparathyroidism, and have a family history of osteoporosis.
Osteoporosis. Coverage for services related to diagnosis, treatment, and appropriate management of osteoporosis including, but not limited to, all Food and Drug Administration approved technologies, including bone mass measurement technologies as deemed Medically Necessary. Outpatient Facility Services Precertification may be required for all outpatient Facility admissions and specific outpatient services, including diagnostic treatment and other services (see the part called GETTING APPROVAL FOR BENEFITS for details). Certain Reconstructive services, wherever performed, require Precertification (see the part called GETTING APPROVAL FOR BENEFITS for details). Your Agreement includes Covered Services in an: • Outpatient Hospital, including ambulatory care and Physician services, • Ambulatory Surgical Center, • Mental Health / Substance Abuse Facility, or • Other approved Facilities Benefits include Facility and related (ancillary) charges, when Medically Necessary, such as: • Surgical rooms and equipment, • Prescription Drugs, including Specialty Drugs dispensed through the Facility, • Anesthesia and anesthesia supplies and services given by the Hospital or other Facility, • Medical and surgical dressings and supplies, casts, and splints, • Diagnostic services, • Therapy services include Physical, Speech and Occupational Therapy Phenylketonuria (PKU) Benefits for the testing and treatment of phenylketonuria (PKU) are paid on the same basis as any other medical condition. Coverage for treatment of PKU shall include those formulas and special food products that are part of a diet prescribed by a licensed Physician and managed by a health care professional in consultation with a Physician who specializes in the treatment of metabolic disease and who participates in or is authorized by Xxxxx. The diet must be deemed Medically Necessary to avert the development of serious physical or mental disabilities or to promote normal development or function as a consequence of PKU.
Osteoporosis. There is a growing appreciation that weight loss procedures may be associated with the development of osteoporosis and bone disease. Gastric surgery and weight loss in morbidly obese individuals can cause increased bone resorption and increased bone loss. Treatment and prevention includes Calcium and Vitamin D supplementation and increased activity. To confirm that you have understood the paragraph above, please initial here: Unexpected Outcomes: I know that the practice of medicine and surgery is not an exact science and I acknowledge that no guarantee has been made about the results that may be obtained from this procedure. I am aware that in the practice of medicine other unexpected problems, risks or complications not discussed may occur. I also understand that during the course of the proposed procedure, unforeseen conditions may be revealed requiring the performance of additional procedures, and I authorize such procedures to be performed. I further acknowledge that no guarantee or promises have been made to me concerning the results of any procedure or treatment. To confirm that you have understood the paragraph above, please initial here: Importance of follow- up I recognize that the proposed one anastomosis gastric bypass is a serious undertaking with known long- term risks. To minimize this risk and to enable them to be detected at an earlier stage and enable prompt treatment, I understand the importance of regular and life-long follow up. I promise that I will make every effort to follow Xx Xxxxxxxxxx’x directions to protect myself from these problems that may be associated with the gastric bypass procedure. I also promise to return to my surgeon’s clinic at 1, 3 and 6 months following surgery and every year thereafter for evaluation and further education. To confirm that you have understood the paragraph above, please initial here: Consent to Procedure and Treatment Having read this form and talked to my surgeon, my signature below acknowledges that I voluntarily give my authorization and consent to the performance of one anastomosis gastric bypass (omega loop / mini gastric bypass) as described by my surgeon. ………………………………………………………………….... ………………….. Patient signature Date ……………………………………………………………………. Print Patient Name …………………………………………………………………..... …………………...
Osteoporosis. Osteoporosis is a disease characterized by low bone mass and structural deterioration of bone tissue, leading to bone fragility and an increased susceptibility to fractures. It is a common condition among the elderly--both men and women. The disease is estimated to affect 1 in 4 women above age 65, 1 in 2 women above age 80 and 1 in 10 men above age 80. The most common consequence of osteoporosis is greatly increased risk of broken bones, especially in the hip region. Osteoporosis is estimated to be responsible for more than 1.5 million hip, vertebral, wrist and other fractures annually. The disease is relatively expensive to treat. The estimated cost of osteoporosis on the health care system amounts to over $13.8 billion per year. It is estimated that by the year 2020, the cost of hip fractures, which account for the highest percentage of fractures, will increase six-fold in the United States. In the U.S. market, osteoporosis therapeutics revenues grew from $2.4 billion in 1998 to $3.0 billion in 1999. This growth is expected to continue through 2006. Several medicines are available to either slow the onset of, or reverse, bone loss. New therapies currently under development should further boost market expansion once they reach the market and will xxxxxx greater patient compliance and ultimately improve the market penetration rate. We are developing with our collaborators, Novartis and Lilly, two promising medicines for the treatment and prevention of osteoporosis. Salmon Calcitonin Treatment with salmon calcitonin has been shown to maintain bone mineral density in the spine and reduce the risk of new vertebral fractures in post- menopausal women with osteoporosis. It is also used in the treatment of Paget's disease, hypercalcemia of cancer and bone pain. Salmon calcitonin is more potent than human calcitonin and is currently available as an injection or nasal spray. Calcitonin has been shown to be effective in slowing bone loss and increasing bone density in the spine. Calcitonin's major advantages are its lack of serious side effects, excellent long term safety profile and ease of administration. Annual worldwide sales of salmon calcitonin are estimated to be in excess of $600 million. There are also some studies that suggest an analgesic effect. As a result, the nasal spray has been used in the treatment of acute vertebral fracture syndrome because of its positive effect on both increasing bone density and decreasing pain. We have conducted collaborati...
Osteoporosis. Frequency, consequences, and risk factors. Archives of Internal Medicine 1996; 156:1399-411.
Osteoporosis. Calcium deficiency may occur years after a gastric bypass. This is a difficult to diagnosis to make until weakness of the bones has already developed. Currently it is best to measure calcium levels and the PTH level (parathyroid hormone). I understand that I am expected to take calcium supplements and supplemental Vitamin D for life after this operation. B vitamin deficiencies: Deficiencies in Thiamine, Niacin, B12 and others have been reported. These B vitamin deficiencies are very rare. Some B vitamin deficiencies can cause irreversible neurological damage. All patients are required to take a multivitamin supplement for life after this operation. Sometimes, additional B vitamin supplements are also required. I understand that it is important to be evaluated regularly for vitamin deficiencies after surgery.
