Common use of Post-Stabilization Services Clause in Contracts

Post-Stabilization Services. Contractor shall cover Post‐ Stabilization Services provided by a Network or non‐Network Provider in any of the following situations: 5.20.1.2.1 Contractor authorized such services; 5.20.1.2.2 such services were administered to maintain the Enrollee’s Stabilized condition within one (1) hour after a request to Contractor for authorization of further Post‐Stabilization Services; or 5.20.1.2.3 Contractor does not respond to a request to authorize further Post‐Stabilization Services within one (1) hour, Contractor could not be contacted, or Contractor and the treating Provider cannot reach an agreement concerning the Enrollee’s care and a Network Provider is unavailable for a consultation, in which case the treating Provider must be permitted to continue the care of the Enrollee until a Network Provider is reached and either concurs with the treating Provider’s plan of care or assumes responsibility for the Enrollee’s care.

Post-Stabilization Services. Contractor shall cover Post‐ Post-Stabilization Services provided by a Network or non‐Network non-Network Provider in any of the following situations:situations:‌‌ 5.20.1.2.1 Contractor authorized such services; 5.20.1.2.2 such services were administered to maintain the Enrollee’s Stabilized condition within one (1) hour after a request to Contractor for authorization of further Post‐Stabilization Post- Stabilization Services; or 5.20.1.2.3 Contractor does not respond to a request to authorize further Post‐Stabilization Post-Stabilization Services within one (1) hour, Contractor could not be contacted, or Contractor and the treating Provider cannot reach an agreement concerning the Enrollee’s care and a Network Provider is unavailable for a consultation, in which case the treating Provider must be permitted to continue the care of the Enrollee until a Network Provider is reached and either concurs with the treating Provider’s plan of care or assumes responsibility for the Enrollee’s care.care.‌

Post-Stabilization Services. Contractor shall cover Post‐ Post- Stabilization Services provided by a Network or non‐Network non-Network Provider in any of the following situations:situations:‌‌ 5.20.1.2.1 Contractor authorized such services; 5.20.1.2.2 such services were administered to maintain the Enrollee’s Stabilized condition within one (1) hour after a request to Contractor for authorization of further Post‐Stabilization Post-Stabilization Services; or 5.20.1.2.3 Contractor does not respond to a request to authorize further Post‐Stabilization Post-Stabilization Services within one (1) hour, Contractor could not be contacted, or Contractor and the treating Provider cannot reach an agreement concerning the Enrollee’s care and a Network Provider is unavailable for a consultation, in which case the treating Provider must be permitted to continue the care of the Enrollee until a Network Provider is reached and either concurs with the treating Provider’s plan of care or assumes responsibility for the Enrollee’s care.