Outpatient Therapeutic Treatment Services. Benefits are available for outpatient services rendered in a health care provider’s office, in the outpatient department of a hospital, in an ambulatory surgical facility, or other facility in connection with a medical or surgical procedure covered under Section 1, Outpatient Facility, Office and Professional Services. Benefits include: A. Hemodialysis and peritoneal dialysis; B. Radiation therapy, including radiation administration; C. Cardiac Rehabilitation benefits for Members who have been diagnosed with significant cardiac disease, or who have suffered a myocardial infarction, or have undergone invasive cardiac treatment immediately preceding referral for Cardiac Rehabilitation. Cardiac Rehabilitation is a comprehensive program involving medical evaluation, prescribed exercise, cardiac risk factor modification, education and counseling. Benefits include: 1. Continuous EKG telemetric monitoring during exercise, EKG rhythm strip with interpretation, physician’s revision of exercise prescription, and follow up examination for physician to adjust medication or change regimen; and 2. Increased outpatient rehabilitation services (physical therapy, speech therapy and occupational therapy) for Cardiac Rehabilitation of ninety (90) visits per therapy per Benefit Period. 3. Services must be provided at a place of service equipped and approved to provide Cardiac Rehabilitation. D. Pulmonary rehabilitation benefits for Members who have been diagnosed with significant pulmonary disease. 1. Limited to one (1) program per lifetime. 2. Services must be provided at a place of service equipped and approved to provide pulmonary rehabilitation services. E. Transfusion services and Infusion Services, including home infusions, infusion of therapeutic agents, medication and nutrients, enteral nutrition into the gastrointestinal tract, chemotherapy, and prescription medications; F. Radioisotope treatment.
Appears in 8 contracts
Samples: Individual Enrollment Agreement, Individual Enrollment Agreement, Individual Enrollment Agreement
Outpatient Therapeutic Treatment Services. Benefits are available for outpatient services rendered in a health care provider’s office, in the outpatient department of a hospital, in an ambulatory surgical facility, or other facility in connection with a medical or surgical procedure covered under Section 1, Outpatient Facility, Office and Professional Services. Benefits include:: SAMPLE
A. Hemodialysis and peritoneal dialysis;
B. Radiation therapy, including radiation administration;
C. Cardiac Rehabilitation benefits for Members who have been diagnosed with significant cardiac disease, or who have suffered a myocardial infarction, or have undergone invasive cardiac treatment immediately preceding referral for Cardiac Rehabilitation. Cardiac Rehabilitation is a comprehensive program involving medical evaluation, prescribed exercise, cardiac risk factor modification, education and counseling. Benefits include:
1. Continuous EKG telemetric monitoring during exercise, EKG rhythm strip with interpretation, physician’s revision of exercise prescription, and follow up examination for physician to adjust medication or change regimen; and
2. Increased outpatient rehabilitation services (physical therapy, speech therapy and occupational therapy) for Cardiac Rehabilitation of ninety (90) visits per therapy per Benefit Period.
3. Services must be provided at a place of service equipped and approved to provide Cardiac Rehabilitation.
D. Pulmonary X. Xxxxxxxxx rehabilitation benefits for Members who have been diagnosed with significant pulmonary disease.
1. Limited to one (1) program per lifetime.
2. Services must be provided at a place of service equipped and approved to provide pulmonary rehabilitation services.
E. Transfusion services and Infusion Services, including home infusions, infusion of therapeutic agents, medication and nutrients, enteral nutrition into the gastrointestinal tract, chemotherapy, chemotherapy and prescription medications;
F. Radioisotope treatment.
Appears in 5 contracts
Samples: Individual Enrollment Agreement for a Qualified Health Plan, Individual Enrollment Agreement for a Qualified Health Plan, Individual Enrollment Agreement for a Qualified Health Plan
Outpatient Therapeutic Treatment Services. Benefits are available for outpatient services rendered in a health care provider’s office, in the outpatient department of a hospital, in an ambulatory surgical facility, or other facility in connection with a medical or surgical procedure covered under Section 1, Outpatient Facility, Office and Professional Services. Benefits include:
A. Hemodialysis and peritoneal dialysis;
B. Radiation therapy, including radiation administration;
C. Cardiac Rehabilitation benefits for Members who have been diagnosed with significant cardiac disease, or who have suffered a myocardial infarction, or have undergone invasive cardiac treatment immediately preceding referral for Cardiac Rehabilitation. Cardiac Rehabilitation is a comprehensive program involving medical evaluation, prescribed exercise, cardiac risk factor modification, education and counseling. Benefits include:
1. Continuous EKG telemetric monitoring during exercise, EKG rhythm strip with interpretation, physician’s revision of exercise prescription, and follow up examination for physician to adjust medication or change regimen; and
2. Increased outpatient rehabilitation services (physical therapy, speech therapy and occupational therapy) for Cardiac Rehabilitation of ninety (90) visits per therapy per Benefit Period.
3. Services must be provided at a place of service equipped and approved to provide Cardiac Rehabilitation.
D. Pulmonary X. Xxxxxxxxx rehabilitation benefits for Members who have been diagnosed with significant pulmonary disease.
1. Limited to one (1) program per lifetime.
2. Services must be provided at a place of service equipped and approved to provide pulmonary rehabilitation services.
E. Transfusion services Infusion and Infusion Servicestransfusion services, including home infusions, infusion of chemotherapeutic and therapeutic agents, medication and nutrients, enteral nutrition into the gastrointestinal tract, chemotherapy, and prescription medications;; and,
F. Radioisotope treatment.
Appears in 4 contracts
Samples: Individual Enrollment Agreement for a Qualified Health Plan, Individual Enrollment Agreement for a Qualified Health Plan, Individual Enrollment Agreement
Outpatient Therapeutic Treatment Services. Benefits are available for outpatient services rendered in a health care provider’s office, in the outpatient department of a hospital, in an ambulatory surgical facility, or other facility in connection with a medical or surgical procedure covered under Section 1, Outpatient Facility, Office and Professional Services. Benefits include:
A. Hemodialysis and peritoneal dialysis;
B. Radiation therapy, including radiation administration;
C. Cardiac Rehabilitation benefits for Members who have been diagnosed with significant cardiac disease, or who have suffered a myocardial infarction, or have undergone invasive cardiac treatment immediately preceding referral for Cardiac Rehabilitation. Cardiac Rehabilitation is a comprehensive program involving medical evaluation, prescribed exercise, cardiac risk factor modification, education and counseling. Benefits include:
1. Continuous EKG telemetric monitoring during exercise, EKG rhythm strip with interpretation, physician’s revision of exercise prescription, and follow up examination for physician to adjust medication or change regimen; and
2. Increased outpatient rehabilitation services (physical therapy, speech therapy and occupational therapy) for Cardiac Rehabilitation of ninety (90) visits per therapy per Benefit Period.
3. Services must be provided at a place of service equipped and approved to provide Cardiac Rehabilitation.
D. Pulmonary rehabilitation benefits for Members who have been diagnosed with significant pulmonary disease.
1. Limited to one (1) program per lifetime.
2. Services must be provided at a place of service equipped and approved to provide pulmonary rehabilitation services.
E. Transfusion services and Infusion Services, including home infusions, infusion of therapeutic agents, medication and nutrients, enteral nutrition into the gastrointestinal tract, chemotherapy, and prescription medications;
F. Radioisotope treatment.
Appears in 3 contracts
Samples: Individual Enrollment Agreement, Individual Enrollment Agreement for a Qualified Health Plan, Individual Enrollment Agreement for a Qualified Health Plan
Outpatient Therapeutic Treatment Services. Benefits are available for outpatient services rendered in a health care provider’s office, in the outpatient department of a hospital, in an ambulatory surgical facility, or other facility in connection with a medical or surgical procedure covered under Section 1, Outpatient Facility, Office and Professional Services. Benefits include:: SAMPLE
A. Hemodialysis and peritoneal dialysis;
B. Radiation therapy, including radiation administration;
C. Cardiac Rehabilitation benefits for Members who have been diagnosed with significant cardiac disease, or who have suffered a myocardial infarction, or have undergone invasive cardiac treatment immediately preceding referral for Cardiac Rehabilitation. Cardiac Rehabilitation is a comprehensive program involving medical evaluation, prescribed exercise, cardiac risk factor modification, education and counseling. Benefits include:
1. Continuous EKG telemetric monitoring during exercise, EKG rhythm strip with interpretation, physician’s revision of exercise prescription, and follow up examination for physician to adjust medication or change regimen; and
2. Increased outpatient rehabilitation services (physical therapy, speech therapy and occupational therapy) for Cardiac Rehabilitation of ninety (90) visits per therapy per Benefit Period.
3. Services must be provided at a place of service equipped and approved to provide Cardiac Rehabilitation.
D. Pulmonary rehabilitation benefits for Members who have been diagnosed with significant pulmonary disease.
1. Limited to one (1) program per lifetime.
2. Services must be provided at a place of service equipped and approved to provide pulmonary rehabilitation services.
E. Transfusion services and Infusion Services, including home infusions, infusion of therapeutic agents, medication and nutrients, enteral nutrition into the gastrointestinal tract, chemotherapy, chemotherapy and prescription medications;
F. Radioisotope treatment.
Appears in 3 contracts
Samples: Individual Enrollment Agreement for a Qualified Health Plan, Individual Enrollment Agreement for a Qualified Health Plan, Individual Enrollment Agreement
Outpatient Therapeutic Treatment Services. Benefits are available for outpatient services rendered in a health care provider’s office, in the outpatient department of a hospital, in an ambulatory surgical facility, or other facility in connection with a medical or surgical procedure covered under Section 1, Outpatient Facility, Office and Professional Services. Benefits include:
A. Hemodialysis and peritoneal dialysis;
B. Radiation Chemotherapy and radiation therapy, including radiation administration;
C. Cardiac Rehabilitation benefits for Members who have been diagnosed with significant cardiac disease, or who have suffered a myocardial infarction, or have undergone invasive cardiac treatment immediately preceding referral for Cardiac Rehabilitation. Cardiac Rehabilitation is a comprehensive program involving medical evaluation, prescribed exercise, cardiac risk factor modification, education and counseling. Benefits include:
1. Continuous EKG telemetric monitoring during exercise, EKG rhythm strip with interpretation, physician’s revision of exercise prescription, and follow up examination for physician to adjust medication or change regimen; and
2. Increased outpatient rehabilitation services (physical therapy, speech therapy and occupational therapy) for Cardiac Rehabilitation of ninety (90) visits per therapy per Benefit Period.
3. Services must be provided at a place of service equipped and approved to provide Cardiac Rehabilitation.
D. Pulmonary X. Xxxxxxxxx rehabilitation benefits for Members who have been diagnosed with significant pulmonary disease.
1. Limited to one (1) program per lifetime.
2. Services must be provided at a place of service equipped and approved to provide pulmonary rehabilitation services.;
E. Transfusion services and Infusion ServicesInfusion, including home infusions, infusion of therapeutic agents, medication and nutrients, enteral nutrition into the gastrointestinal tract, chemotherapytherapy, and prescription medicationstransfusion services;
F. Electroshock therapy; and,
G. Radioisotope treatment.
Appears in 2 contracts
Samples: In Network Group Contract, In Network Group Contract
Outpatient Therapeutic Treatment Services. Benefits are available for outpatient services rendered in a health care provider’s office, in the outpatient department of a hospital, in an ambulatory surgical facility, or other facility in connection with a medical or surgical procedure covered under Section 1, Outpatient Facility, Office and Professional Services. Benefits include:
A. Hemodialysis and peritoneal dialysis;
B. Radiation therapy, including radiation administration;
C. Cardiac Rehabilitation benefits for Members who have been diagnosed with significant cardiac disease, or who have suffered a myocardial infarction, or have undergone invasive cardiac treatment immediately preceding referral for Cardiac Rehabilitation. Cardiac Rehabilitation is a comprehensive program involving medical evaluation, prescribed exercise, cardiac risk factor modification, education and counseling. Benefits include:
1. Continuous EKG telemetric monitoring during exercise, EKG rhythm strip with interpretation, physician’s revision of exercise prescription, and follow up examination for physician to adjust medication or change regimen; and
2. Increased outpatient rehabilitation services (physical therapy, speech therapy and occupational therapy) for Cardiac Rehabilitation of ninety (90) visits per therapy per Benefit Period, combined In-Network and Out-of-Network.
3. Services must be provided at a place of service equipped and approved to provide Cardiac Rehabilitation.
D. Pulmonary rehabilitation benefits for Members who have been diagnosed with significant pulmonary disease.
1. Limited to one (1) program per lifetime, combined In-Network and Out-of- Network.
2. Services must be provided at a place of service equipped and approved to provide pulmonary rehabilitation services.
E. Transfusion services Infusion and Infusion Servicestransfusion services, including home infusions, infusion of chemotherapeutic and therapeutic agents, medication and nutrients, enteral nutrition into the gastrointestinal tract, chemotherapy, and prescription medications;; and,
F. Radioisotope treatment.
Appears in 1 contract
Outpatient Therapeutic Treatment Services. Benefits are available for outpatient services rendered in a health care provider’s office, in the outpatient department of a hospital, in an ambulatory surgical facility, or other facility in connection with a medical or surgical procedure covered under Section 1, Outpatient Facility, Office and Professional Services. Benefits include:
A. Hemodialysis and peritoneal dialysis;
B. Radiation therapy, including radiation administration;
C. Cardiac Rehabilitation benefits for Members who have been diagnosed with significant cardiac disease, or who have suffered a myocardial infarction, or have undergone invasive cardiac treatment immediately preceding referral for Cardiac Rehabilitation. Cardiac Rehabilitation is a comprehensive program involving medical evaluation, prescribed exercise, cardiac risk factor modification, education and counseling. Benefits include:
1. Continuous EKG telemetric monitoring during exercise, EKG rhythm strip with interpretation, physician’s revision of exercise prescription, and follow up examination for physician to adjust medication or change regimen; and
2. Increased outpatient rehabilitation services (physical therapy, speech therapy and occupational therapy) for Cardiac Rehabilitation of ninety (90) visits per therapy per Benefit Period.
3. Services must be provided at a place of service equipped and approved to provide Cardiac Rehabilitation.
D. Pulmonary rehabilitation benefits for Members who have been diagnosed with significant pulmonary disease.
1. Limited to one (1) program per lifetime.
2. Services must be provided at a place of service equipped and approved to provide pulmonary rehabilitation services.. SAMPLE
E. Transfusion services and Infusion Services, including home infusions, infusion of therapeutic agents, medication and nutrients, enteral nutrition into the gastrointestinal tract, chemotherapy, and prescription medications;
F. Radioisotope treatment.
Appears in 1 contract
Samples: Individual Enrollment Agreement
Outpatient Therapeutic Treatment Services. Benefits are available for outpatient services rendered in a health care provider’s office, in the outpatient department of a hospital, in an ambulatory surgical facility, or other facility in connection with a medical or surgical procedure covered under Section 1, Outpatient Facility, Office and Professional Services. Benefits include:
A. Hemodialysis and peritoneal dialysis;
B. Radiation Chemotherapy and radiation therapy, including radiation administration;
C. Cardiac Rehabilitation benefits for Members who have been diagnosed with significant cardiac disease, or who have suffered a myocardial infarction, or have undergone invasive cardiac treatment immediately preceding referral for Cardiac Rehabilitation. Cardiac Rehabilitation is a comprehensive program involving medical evaluation, prescribed exercise, cardiac risk factor modification, education and counseling. Benefits include:
1. Continuous EKG telemetric monitoring during exercise, EKG rhythm strip with interpretation, physician’s revision of exercise prescription, and follow up examination for physician to adjust medication or change regimen; and
2. Increased outpatient rehabilitation services (physical therapy, speech therapy and occupational therapy) for Cardiac Rehabilitation of ninety (90) visits per therapy per Benefit Period.
3. Services must be provided at a place of service equipped and approved to provide Cardiac Rehabilitation.
D. Pulmonary rehabilitation benefits for Members who have been diagnosed with significant pulmonary disease.
1. Limited to one (1) program per lifetime.
2. Services must be provided at a place of service equipped and approved to provide pulmonary rehabilitation services.;
E. Transfusion services and Infusion ServicesInfusion, including home infusions, infusion of therapeutic agents, medication and nutrients, enteral nutrition into the gastrointestinal tract, chemotherapytherapy, and prescription medicationstransfusion services;
F. Electroshock therapy; and,
G. Radioisotope treatment.
Appears in 1 contract
Samples: In Network Group Contract
Outpatient Therapeutic Treatment Services. Benefits are available for outpatient services rendered in a health care provider’s office, in the outpatient department of a hospital, in an ambulatory surgical facility, or other facility in connection with a medical or surgical procedure covered under Section 1, Outpatient Facility, Office and Professional Services. Benefits include:
A. Hemodialysis and peritoneal dialysis;
B. Radiation therapy, including radiation administration;
C. Cardiac Rehabilitation benefits for Members who have been diagnosed with significant cardiac disease, or who have suffered a myocardial infarction, or have undergone invasive cardiac treatment immediately preceding referral for Cardiac Rehabilitation. Cardiac Rehabilitation is a comprehensive program involving medical evaluation, prescribed exercise, cardiac risk factor modification, education and counseling. Benefits include:
1. Continuous EKG telemetric monitoring during exercise, EKG rhythm strip with interpretation, physician’s revision of exercise prescription, and follow up examination for physician to adjust medication or change regimen; and
2. Increased outpatient rehabilitation services (physical therapy, speech therapy and occupational therapy) for Cardiac Rehabilitation of ninety (90) visits per therapy per Benefit Period.
3. Services must be provided at a place of service equipped and approved to provide Cardiac Rehabilitation.
D. Pulmonary rehabilitation benefits for Members who have been diagnosed with significant pulmonary disease.
1. Limited to one (1) program per lifetime.
2. Services must be provided at a place of service equipped and approved to provide pulmonary rehabilitation services.
E. Transfusion services Infusion and Infusion Servicestransfusion services, including home infusions, infusion of chemotherapeutic and therapeutic agents, medication and nutrients, enteral nutrition into the gastrointestinal tract, chemotherapy, and prescription medications;; and,
F. Radioisotope treatment.
Appears in 1 contract
Samples: Individual Enrollment Agreement for a Qualified Health Plan