Outpatient Surgery Sample Clauses
Outpatient Surgery. A $100 single and $200 family combined annual deductible will apply to Outpatient Surgery after which 100% Coverage will apply.
Outpatient Surgery. Any absence for which the District is required to provide a reasonable accommodation
Outpatient Surgery. Discipline issued to employees under the Sick Day Policy carries over from fiscal year to fiscal year. However, if an employee goes twelve (12) consecu- tive months without incurring any discipline under the Sick Day Policy, the disciplines he or she has will be removed from consideration; and the employee will start over on progressive discipline. Any District authorized exceptions would be in writing and available for the Union President to review.
Outpatient Surgery. Procedures including all routine Medical Services required during the Outpatient Visit including but not limited to all medical supplies, central service items, and nursing support or care.
Outpatient Surgery. We will provide benefits for Surgery, abortion services, sterilizations and one attempt at reversal of sterilization. These services are subject to prior authorization. You must pay the Cost Share listed on your Schedule for each surgery. Voluntary sterilization procedures for females are covered with no Cost Share. Voluntary sterilization procedures for males are subject to the deductible for members in plans that are titled “MVP High Deductible” (an IRS HSA Qualified High Deductible Health Plan).
Outpatient Surgery. This includes any diagnostic or therapeutic surgery prescribed and carried out by a specialist in the relevant area included in the Insurer’s Directory of Practitioners at an authorised healthcare facility, that normally requires an operating theatre. de cobertura con cargo al contrato de seguro de la madre, hasta un máximo de 30 xxxx desde la fecha de su nacimiento; para continuidad asistencial a cargo de la Entidad, es imprescindible el alta del recién nacido en ASISA dentro del citado período, según lo previsto en el apartado c) de la Condición General Xxxxxx. Para tratamiento de los procesos que, a juicio del especialista del Cuadro Médico, no puedan tra- tarse en el domicilio o de forma ambulatoria con las técnicas correctas y precisen internamiento. En estos casos no se incluye cama de acompa- ñante. Se establece una limitación de 50 xxxx de Hospitalización por anualidad de seguro. - Hospitalización en unidades especializadas, como Unidad de Vigilancia Intensiva (U.V.I.) o Unidad Coronaria. En estos casos no se incluye cama de acompañante.
Outpatient Surgery. This includes any diagnostic or therapeutic sur- xxxx prescribed and carried out by a specialist in the relevant area included in the Insurer’s Direc- tory of Practitioners at an authorised healthcare facility, that normally requires an operating the- atre. Siempre que el parto/cesárea haya sido cubier- to por ASISA, la hospitalización del recién nacido será de cobertura con cargo al contrato de segu- ro de la madre, hasta un máximo de 30 xxxx des- de la fecha de su nacimiento; para continuidad asistencial a cargo de la Entidad, es imprescin- xxxxx el xxxx del recién nacido en ASISA dentro del citado período, según lo previsto en el apar- tado c) de la Condición General Octava. Para tratamiento de los procesos que, a juicio del especialista del Cuadro Médico, no puedan tra- tarse en el domicilio o de forma ambulatoria con las técnicas correctas y precisen internamiento. En estos casos no se incluye cama de acompa- ñante. Se establece una limitación de 50 xxxx de Hospitalización por anualidad de seguro. - Hospitalización en unidades especializadas, como Unidad de Vigilancia Intensiva (U.V.I.) o Unidad Coronaria. En estos casos no se incluye cama de acompañante.
Outpatient Surgery. Outpatient surgery may be performed in an Acute Care Hospital or Ambulatory Surgical Facility. Benefits for Ambulatory Surgical Facilities include those outpatient surgeries that, in the judgment of the Provider, are nonlife threatening, can be provided in a facility other than an Acute Care Hospital, and are performed at an Ambulatory Surgical Facility by a duly licensed associated Physician or allied health professional practicing within the scope of his/her licensure and specialty. Outpatient surgeries performed in an Acute Care Hospital may be subject to higher Cost Sharing Amounts.
Outpatient Surgery. Eligible employees will receive their regular pay for the winter break if they work their assigned work hours as scheduled. To be eligible to receive their regular pay over the winter break, employees who are assigned to work more than four (4) hours each work day at the start of the school year may not be absent from work for more than the equivalent of three (3) work days between the start of the school year through the start of winter break. To be eligible to receive their regular pay over the winter break, employees who are assigned to work four (4) hours or fewer each work day at the start of the school year may not be absent from work for more than the equivalent of one (1) work day from the start of the school year through the start of winter break. Eligible employees will receive their regular pay for the spring break if they work their assigned work hours as scheduled. To be eligible to receive their regular pay over the spring break, employees who are assigned to work more than four (4) hours each work day at the start of winter break may not be absent from work for more than the equivalent of three (3) work days between the start of winter break through the start of spring break. To be eligible to receive their regular pay over spring break, employees who are assigned to work four (4) hours or fewer each work day at the start of winter break may not be absent from work for more than the equivalent of one
Outpatient Surgery. Case Rates ------------------- Arthroscopies $[ ** ] Laparoscopic Procedures $[ ** ] Lithotripsy $[ ** ] Fractures of Hips and Pelvis $[ ** ] Cardiac Pacemaker Device Replacement $[ ** ] Inguinal Hernia $[ ** ] Breast Biopsy w/ or w/o Localization $[ ** ] Cataract w/IOI $[ ** ] Cataract w/Lens $[ ** ] Bunionectomy $[ ** ] Other Outpatient Surgical Procedures [ ** ] ATTACHMENT A4-1 HOSPITAL SERVICES VALUATION SCHEDULE ST JUDE MEDICAL CENTER PROSPECT MEDICAL GROUP PAGE 2 Exclusions: (Reimbursed Separately) --------------------------------- Excluded from Case Rates and/or per diems Prosthesis/Implants/DME/Chole-K/ [ ** ] Pacemakers/Valves/Balloon Catheters/ DCA cutting Devices/Imaging Catheters Emergency Room: $0-$300 in Gross Charges [ ** ] $301 and greater [ ** ] Risk Pool Distribution: St. Jude Medical Center [ ** ] Prospect Medical Group [ ** ] Limited Downside Risk-Prospect Med Group [ ** ] St. Jude Medical Center Stop Loss Reinsurance [ ** ] BED DAYS BONUS SCHEDULE Bed Days/Thousand: Total member months Bonus ------------------ ------ 1,200 or greater [ ** ] 1,000 to 1,199 [ ** ] 951 to 999 [ ** ] 900 to 950 [ ** ] 850 to 899 [ ** ] 800 to 849 [ ** ] 700 to 799 [ ** ] 600 to 699 [ ** ] Under 600 [ ** ] 41a ATTACHMENT B SECURE HORIZONS MEDICAL AND HOSPITAL SUBSCRIBERS AGREEMENT Secure Horizons Medical and Hospital Subscriber Agreement is available upon request. A summary of the Schedule of Benefits is attached. ATTACHMENT C COMPENSATION CAPITATION PAYMENTS - PacifiCare shall make monthly Capitation Payments to IPA based on the number of Subscribers eligible to receive Medical Services from IPA.