Common use of REQUIRED SECOND SURGICAL OPINION Clause in Contracts

REQUIRED SECOND SURGICAL OPINION. If a surgeon has recommended a non-emer- gency surgical procedure, the insured must notify USA Medical Services at least seventy-two (72) hours prior to the scheduled procedure. If a second surgical opinion is deemed necessary by either the insurer or USA Medical Services, it must be conducted by a physician chosen and arranged by USA Medical Services. Only those second surgical opinions required and coordinated by USA Medical Services are covered. In the event the second surgical opinion contradicts or does not confirm the need for surgery, the insurer will also pay for a third surgical opinion from a physician chosen in agreement between the insured and USA Medical Services. If the second or third surgical opinion confirms the need for surgery, benefits for the surgery will be paid according to this policy. IF THE INSURED DOES NOT OBTAIN A REQUIRED SECOND SURGICAL OPINION, THE INSURED WILL BE RESPONSIBLE FOR THIRTY PERCENT (30%) OF ALL COVERED MEDICAL AND HOSPITAL CHARGES RELATED TO THE CLAIM, IN ADDITION TO THE PLAN DEDUCTIBLE.

Appears in 9 contracts

Samples: www.bupasalud.com, www.bupasalud.com, www.bupasalud.com

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REQUIRED SECOND SURGICAL OPINION. If a surgeon has recommended a that an Insured undergo any non-emer- gency emergency surgical procedure, the insured Insured must notify USA Medical Services at least seventy-two (72) hours prior to the scheduled procedure. If a second surgical opinion is deemed necessary by either the insurer Insurer or USA Medical Services, it must be conducted by a physician chosen and arranged by USA Medical Services. Only those second surgical opinions required and coordinated by USA Medical Services are covered. In the event the second surgical opinion contradicts or does not confirm the need for surgery, the insurer Insurer will also pay for a third surgical opinion from a physician chosen in agreement between the insured and by USA Medical Services. If the second or third surgical opinion confirms the need for surgery, benefits for the surgery will be paid according to this policy. IF THE INSURED DOES NOT OBTAIN A REQUIRED SECOND SURGICAL OPINIONOPINION , THE INSURED WILL BE RESPONSIBLE FOR THIRTY PERCENT (30%) OF ALL COVERED MEDICAL AND HOSPITAL CHARGES RELATED TO THE CLAIM, CLAIM IN ADDITION TO THE PLAN DEDUCTIBLEDEDUCTIBLE AND COINSURANCE. (IF APPLICABLE).

Appears in 4 contracts

Samples: www.bupasalud.com, www.bupasalud.com.do, www.bupasalud.com.co

REQUIRED SECOND SURGICAL OPINION. If a surgeon has recommended a non-emer- gency emergency surgical procedure, the insured must notify USA Medical Services at least seventy-two (72) hours prior to the scheduled procedure. If a second surgical opinion is deemed necessary by either the insurer or USA Medical ServicesSer- vices, it must be conducted by a physician chosen and arranged by USA Medical Services. Only those second surgical opinions required and coordinated by USA Medical Services are covered. In the event the second surgical opinion contradicts contra- dicts or does not confirm the need for surgery, the insurer will also pay for a third surgical opinion from a physician chosen in agreement between the insured and USA Medical Services. If the second or third surgical opinion confirms the need for surgery, benefits for the surgery will be paid according to this policy. IF THE INSURED DOES NOT OBTAIN A REQUIRED SECOND SURGICAL OPINIONOPIN- ION, THE INSURED WILL BE RESPONSIBLE FOR THIRTY PERCENT (30%) OF ALL COVERED MEDICAL AND HOSPITAL CHARGES RELATED TO THE CLAIM, IN ADDITION TO THE PLAN DEDUCTIBLE.

Appears in 2 contracts

Samples: www.bupasalud.com.pa, www.bupasalud.com.pa

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REQUIRED SECOND SURGICAL OPINION. If a surgeon has recommended a that an Insured undergo any non-emer- gency emergency surgical procedure, the insured Insured must notify USA Medical Services at least seventy-two (72) hours prior to the scheduled procedure. If a second surgical opinion is deemed necessary by either the insurer Insurer or USA Medical Services, it must be conducted by a physician chosen and arranged by USA Medical Services. Only those second surgical opinions required and coordinated by USA Medical Services are covered. In the event the second surgical opinion contradicts or does not confirm the need for surgery, the insurer Insurer will also pay for a third surgical opinion from a physician chosen in agreement between the insured and by USA Medical Services. If the second or third surgical opinion confirms the need for surgery, benefits for the surgery will be paid according to this policy. IF THE INSURED DOES NOT OBTAIN A REQUIRED SECOND SURGICAL OPINIONOPIN- ION, THE INSURED WILL BE RESPONSIBLE FOR THIRTY PERCENT (30%) OF ALL COVERED MEDICAL AND HOSPITAL CHARGES RELATED TO THE CLAIM, CLAIM IN ADDITION TO THE PLAN DEDUCTIBLEDEDUCTIBLE AND COINSURANCE (IF APPLICABLE).

Appears in 2 contracts

Samples: www.bupasalud.com, www.bupasalud.com

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