Common use of OUTPATIENT FACILITY, OFFICE, AND PROFESSIONAL SERVICES Clause in Contracts

OUTPATIENT FACILITY, OFFICE, AND PROFESSIONAL SERVICES. CareFirst BlueChoice provides coverage for the services listed below in Contracting Provider’s offices or other Contracting Provider facilities. Prior authorization is required for all outpatient services performed in the outpatient department of a hospital, including but not limited to, outpatient surgery, specialty imaging, diagnostic, laboratory and x-ray services, Outpatient Rehabilitative Services, and Infusion Services. Benefits will not be approved at these locations if CareFirst BlueChoice determines that the procedure can be provided in a medically appropriate manner within a physician's office or other less intensive and less costly setting. If prior authorization is not obtained, benefits for outpatient services performed in the outpatient department of a hospital are not covered. Prior authorization is the responsibility of the Contracting Provider and a Member cannot be held liable when a Contracting Provider fails to obtain prior authorization. Prior authorization is not required for Clinic Visits rendered in a hospital, hospital clinic or health care provider’s office on a hospital campus.

OUTPATIENT FACILITY, OFFICE, AND PROFESSIONAL SERVICES. CareFirst BlueChoice provides coverage for the services listed below in Contracting Provider’s Providers’ offices or in other Contracting Provider facilities. Prior authorization is required for all outpatient services performed in the outpatient department of a hospital, including but not limited to, outpatient surgery, specialty imaging, diagnostic, laboratory and x-ray services, Outpatient Rehabilitative Services, and Infusion Services. Benefits will not be approved at these locations if CareFirst BlueChoice determines that the procedure can be provided in a medically appropriate manner within a physician's office or other less intensive and less costly setting. If prior authorization is not obtained, benefits for outpatient services performed in the outpatient department of a hospital are not covered. Prior authorization is the responsibility of the Contracting Provider contracting provider and a Member member cannot be held liable when a Contracting Provider contracting provider fails to obtain prior authorization. Prior authorization is not required for Clinic Visits Visits/ Outpatient Services rendered in a hospital, hospital clinic or health care provider’s office on a hospital campus.

OUTPATIENT FACILITY, OFFICE, AND PROFESSIONAL SERVICES. CareFirst BlueChoice provides coverage for the services listed below in Contracting Provider’s Providers’ offices or in other Contracting Provider facilities. Prior authorization is required for all outpatient services performed in the outpatient department of a hospital, including but not limited to, outpatient surgery, specialty imaging, diagnostic, laboratory and x-ray services, Outpatient Rehabilitative Services, and Infusion Services. Benefits will not be approved at these locations if CareFirst BlueChoice determines that the procedure can be provided in a medically appropriate manner within a physician's office or other less intensive and less costly setting. If prior authorization is not obtained, benefits for outpatient services performed in the outpatient department of a hospital are not covered. Prior authorization is the responsibility of the Contracting Provider and a Member member cannot be held liable when a Contracting Provider fails to obtain prior authorization. Prior authorization is not required for Clinic Visits Visits/ Outpatient Services rendered in a hospital, hospital clinic or health care provider’s office on a hospital campus.