Emergency Calls IP Phones need an additional power supply to operate. In the event of a power failure it is your responsibility to ensure you have the means to make emergency calls. In accordance with paragraph 13.2, we will not be liable for any loss or damage (financial or otherwise) where you fail to do so.
Medical Care and Emergency Leave An employee is entitled to a leave of absence without pay because of any of the following:
Medical Emergencies If you encounter a medical emergency that makes you unable to pay your bill for a period of time, or that requires your account remain active, even if it has already been suspended or disconnected, Viasat may payment or reconnection options available for you. You must contact Viasat immediately upon learning of such emergency to determine what options are available in your situation. If you reside in Maine or Pennsylvania, please contact us regarding the specific procedures to follow for relief.
Medical Emergency A medical condition which manifests itself by acute symptoms of sufficient severity (including severe pain) such that a prudent layperson, who possesses an average knowledge of health and medicine, could reasonably expect the absence of immediate attention to result in 1) placing the health of the individual (or with respect to a pregnant woman, the health of the woman or her unborn child) in serious jeopardy; 2) serious impairment to bodily functions; or 3) serious dysfunction of any bodily organ or part. Examples of a medical emergency are severe pain, suspected heart attacks and fractures. Examples of a non- medical emergency are minor cuts and scrapes. Medically Necessary and Medical Necessity Services a physician, exercising prudent clinical judgment, would use with a patient to prevent, evaluate, diagnose or treat an illness or injury or its symptoms. These services must: Agree with generally accepted standards of medical practice Be clinically appropriate in type, frequency, extent, site and duration., They must also be considered effective for the patient’s illness, injury or disease Not be mostly for the convenience of the patient, physician, or other healthcare provider. They do not cost more than another service or series of services that are at least as likely to produce equivalent therapeutic or diagnostic results for the diagnosis or treatment of that patient’s illness, injury or disease. For these purposes, “generally accepted standards of medical practice” means standards that are based on credible scientific evidence published in peer reviewed medical literature. This published evidence is recognized by the relevant medical community, physician specialty society recommendations and the views of physicians practicing in relevant clinical areas and any other relevant factors. Member Any person covered under this plan. Mental Condition A condition that is listed in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM). This does not include conditions and treatments for chemical dependency. Mental Health Services Medically necessary outpatient and inpatient services provided to treat mental conditions. State and federal law require that the copays and coinsurance for mental health services will be no more than the copays and coinsurance for medical and surgical services. Prescription drugs for mental conditions are covered under the same terms and conditions as other prescription drugs covered under this plan.
Interconnection Customer Compensation for Actions During Emergency Condition The CAISO shall compensate the Interconnection Customer in accordance with the CAISO Tariff for its provision of real and reactive power and other Emergency Condition services that the Interconnection Customer provides to support the CAISO Controlled Grid during an Emergency Condition in accordance with Article 11.6.
Claims Review Findings a. Narrative Results.
Plan Arrangements Eligibility – Claim Types All claim types are eligible to be processed through Inter-Plan Arrangements, as described above, except for all dental benefits, and those prescription drug benefits or vision benefits that may be administered by a third party contracted by us to provide the specific service or services. BlueCard® Program Under the BlueCard® Program, when you receive covered healthcare services within the geographic area served by a Host Blue, BCBSRI will remain responsible for doing what we agreed to in the contract. However, the Host Blue is responsible for contracting with and generally handling all interactions with its participating providers. When you receive covered healthcare services outside our service area and the claim is processed through the BlueCard Program, the amount you pay for covered healthcare services is calculated based on the lower of: • the billed covered charges for your covered services; or • the negotiated price that the Host Blue makes available to BCBSRI. Often, this “negotiated price” will be a simple discount that reflects an actual price that the Host Blue pays to your healthcare provider. Sometimes, it is an estimated price that takes into account special arrangements with your healthcare provider or provider group that may include types of settlements, incentive payments and/or other credits or charges. Occasionally, it may be an average price, based on a discount that results in expected average savings for similar types of healthcare providers after taking into account the same types of transactions as with an estimated price. Estimated pricing and average pricing also take into account adjustments to correct for over- or underestimation of past pricing of claims, as noted above. However, such adjustments will not affect the price we have used for your claim because they will not be applied after a claim has already been paid. Negotiated (non–BlueCard Program) Arrangements With respect to one or more Host Blues, in certain instances, instead of using the BlueCard Program, we may process your claims for covered healthcare services through Negotiated Arrangements for National Accounts. The amount you pay for covered healthcare services under this arrangement will be calculated based on the negotiated price (refer to the description of negotiated price in the BlueCard® Program section above) made available to us by the Host Blue.
Claims Review Objective A clear statement of the objective intended to be achieved by the Claims Review.
Claims Review The IRO shall perform the Claims Review annually to cover each of the five Reporting Periods. The IRO shall perform all components of each Claims Review.
TELEPHONE & EMERGENCY PROCEDURES If you need to contact Xxxxxxxxx Xxxxx between sessions, please leave a message at the answering service (000-000-0000 and your call will be returned as soon as possible. Xxxxxxxxx Xxxxx checks her messages a few times during the daytime only, unless she is out of town and will return your call within 24 hours. If an emergency situation and you are in a crisis situation, and Xxxxxxxxx Xxxxx cannot be reached, you may call 911, or 24-Hour Crisis Hotlines – National 1-800-273-TALK (8255) National Suicide Prevention Lifeline, Suicide/Crisis Hotlines of Maricopa 0-000-000-0000 or 000-000-0000, or go immediately to your local hospital emergency room. Please do not use email or faxes for emergencies. Xxxxxxxxx Xxxxx may be with a client, out of the office or on vacation and may be unable to check her email or faxes daily. PAYMENTS & INSURANCE REIMBURSEMENT: Clients are expected to pay at initial appointment an intake assessment fee of $200 per 90 minute session (for individual) or $250 for 90 minute session per couple or family. Clients are expected to pay the standard fee of $120.00 per 45 minutes (individual), 150 per 60 for (individual) or $150.00 per 45 minutes for (couple) and 175 per 60 minutes (couple and family) session; at the end of each session or at the end of the month unless other arrangements have been made. Telephone conversations, site visits, writing and reading of reports, consultation with other professionals, release of information, reading records, longer sessions, travel time, etc. will be charged at the same rate, unless indicated and agreed upon otherwise. Please notify Xxxxxxxxx Xxxxx if any problems arise during the course of therapy regarding your ability to make timely payments. Clients who carry insurance should remember that professional services are rendered and charged to the clients and not to the insurance companies. Unless agreed upon differently, Xxxxxxxxx Xxxxx will provide you with a copy of your receipt on a monthly basis, which you can then submit to your insurance company for reimbursement, if you so choose. As was indicated in the section, Health Insurance & Confidentiality of Records, you must be aware that submitting a mental health invoice for reimbursement carries a certain amount of risk. Not all issues/conditions/problems, which are dealt with in psychotherapy, are reimbursed by insurance companies. It is your responsibility to verify the specifics of your coverage. If your account is overdue (unpaid) and there is no written agreement on a payment plan, Xxxxxxxxx Xxxxx can use legal or other means (courts, collection agencies, etc.) to obtain payment.
