SECOND OPINION POLICY Sample Clauses

SECOND OPINION POLICY. It is the policy of CDN that a second opinion obtained from a participating panel provider will be a covered benefit. The covered benefit will need an approval from the Plan. A second opinion is encouraged as a positive component of quality of care.
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SECOND OPINION POLICY. A second opinion may be required at Our discretion prior to the scheduling of certain Health Services. We will advise You if a proposed Health Service is subject to the second opinion policy. If so, You must consult with a second Participating Provider prior to the scheduling of the service.
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SECOND OPINION POLICY. Coverage of certain Health Services as Network Benefits may require that Covered Persons consult a second Network Physician prior to the scheduling of the Health Service. The Company will notify them that a particular Health Service is subject to a second opinion Policy and will inform them of the required procedure for obtaining a second opinion.
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SECOND OPINION POLICY. You may request a second medical opinion, as may others on your behalf, including your family, your PCP and the IDT. If you desire a second opinion you should notify your PCP or nurse practitioner. GMWP will issue a decision on second opinions within 72 hours. The timeline is available upon request by calling the GMWP Medical Director at at (000) 000-0000 at any time. For the hearing-impaired (TTY/TDD), please call (000) 000-0000. A tuberculosis (TB) skin test(s) or chest X-ray is required upon enrollment and annually as appropriate. GMWP will provide treatment if the TB test is positive. You will be responsible to pay for unauthorized services, except for Emergency Services and Urgent Care (see “Reimbursement Provisions” in CHAPTER 5). Payment for services provided under this Enrollment Agreement will be made by GMWP to the provider. You cannot be required to pay anything that is owed by GMWP to the selected providers.
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SECOND OPINION POLICY. You may request a second medical opinion, as may others on your behalf, including your family, your PCP, and the IDT. If you desire a second opinion, you should notify your PCP or nurse practitioner. A tuberculosis (TB) skin test(s) or chest X-ray is required upon enrollment. FHCN PACE will provide treatment if the TB test is positive. You may be fully and personally responsible to pay for unauthorized or out-of-PACE-network services, except for Emergency Services and Urgent Care (see “Reimbursement Provisions” in CHAPTER 5).
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SECOND OPINION POLICY. You may request a second medical opinion, as may others on your behalf, including your family, your PCP and the IDT. If you desire a second opinion, you should notify your PCP or nurse practitioner. CalOptima PACE will issue a decision on second opinions within 72 hours. The timeline is available upon request by calling 0-000-000-0000 or contacting: CalOptima PACE 00000 Xxxxxx Xxxxx Xxxx. Garden Grove, CA 92843 A tuberculosis (TB) skin test(s) or chest X-ray is required upon enrollment. CalOptima PACE will provide treatment if the TB test is positive. You will be responsible to pay for unauthorized services, except for emergency services and urgent care. (See “Reimbursement Provisions” in Chapter 5.)
Sample 1
SECOND OPINION POLICY. You may request a second medical opinion, as may others on your behalf, including your family, your PCP and the IDT. If you desire a second opinion you should notify your PCP or nurse practitioner. {PACE Organization} will issue a decision on second opinions within 72 hours. The timeline is available upon request by calling {insert telephone number here} or contacting {insert name and address of appropriate entity here}. You may receive a standing referral to a medical specialist if you have HIV or AIDS or if your PCP determines that you need the continuing care of a specialist. Your PCP is responsible for approving a standing referral and will do so in accordance with {PACE Program’s} standing referral procedures. Additional information regarding standing referrals, including a list of specialists with expertise in caring for people with HIV or AIDS is available upon request by contacting your PCP or {list additional contact person or place here} at {insert telephone number here}. Any claim that you may have against {PACE Organization} or with respect to services provided by {PACE Organization} must be brought by you within two years from the date you receive the service for which the claim is brought. In the case of personal injuries, the claim must be brought within one year from the date on which those injuries were sustained. A tuberculosis skin test(s) or chest X-ray is required prior to enrollment. If you do not meet a certain condition of {PACE Organization} to receive a particular service, we reserve the right to waive such a condition if we, in our judgment, determine that you could medically benefit from receiving that service. However, if we do waive a condition for you in one instance, this does not mean that we are obligated to waive that condition or any other condition for you on any other occasion.
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SECOND OPINION POLICY. You may request a second medical opinion, as may others on your behalf, including your family, your Primary Care Physician and the Interdisciplinary Team. If you desire a second opinion you should notify your Primary Care Physician or Nurse Practitioner. {PACE Program} will issue a decision on second opinions within 72 hours. The timeline is available upon request by calling {insert phone # here} or contacting {insert name and address of appropriate entity here}. You may receive a standing referral to a medical specialist if you have HIV or AIDS or if your Primary Care Physician determines that you need the continuing care of a specialist. Your Primary Care Physician is responsible for approving a standing referral and will do so in accordance with {PACE Program’s} standing referral procedures. Additional information regarding standing referrals, including a list of specialists with expertise in caring for people with HIV or AIDS is available upon request by contacting your Primary Care Physician or {list additional contact person or place here} at {insert telephone # here}. Any claim that you may have against {PACE Program} or with respect to services provided by {PACE Program} must be brought by you within two years from the date you receive the service for which the claim is brought. In the case of personal injuries, the claim must be brought within one year from the date on which those injuries were sustained. A tuberculosis skin test(s) or chest X-ray is required prior to enrollment. If you do not meet a certain condition of {PACE Program} to receive a particular service, we reserve the right to waive such a condition if we, in our judgment, determine that you could medically benefit from receiving that service. However, if we do waive a condition for you in one instance, this does not mean that we are obligated to waive that condition or any other condition for you on any other occasion. You will be responsible to pay for unauthorized services, except for Emergency Services and Urgently Needed Care (see “Reimbursement Provisions” in CHAPTER FIVE). Payment for services provided under this Contract will be made by {PACE Program} to the provider. You cannot be required to pay anything that is owed by {PACE Provider} to the selected providers.
Sample 1
SECOND OPINION POLICY. You may request a second medical opinion, as may others on your behalf, including your family, your PCP and the IDT. If you desire a second opinion you should notify your PCP or nurse practitioner. {PACE Organization} will issue a decision on second opinions within 72 hours. The timeline is available upon request by calling {insert telephone number here} or contacting {insert name and address of appropriate entity here}. A tuberculosis (TB) skin test(s) or chest X-ray is required upon enrollment. {PACE Organization} will provide treatment if the TB test is positive. You will be responsible to pay for unauthorized services, except for Emergency Services and Urgent Care (see “Reimbursement Provisions” in CHAPTER 5). Payment for Services under this Enrollment Agreement Payment for services provided under this Enrollment Agreement will be made by {PACE Organization} to the provider. You cannot be required to pay anything that is owed by {PACE Organization} to the selected providers.
Sample 1

Related to SECOND OPINION POLICY

  • Second Opinions The Member may access a second opinion from a Network Provider regarding a medical diagnosis or treatment plan. The Member may request Preauthorization or may visit a KFHPWA-designated Specialist for a second opinion. When requested or indicated, second opinions are provided by Network Providers and are covered with Preauthorization, or when obtained from a KFHPWA-designated Specialist. Coverage is determined by the Member's EOC; therefore, coverage for the second opinion does not imply that the services or treatments recommended will be covered. Preauthorization for a second opinion does not imply that KFHPWA will authorize the Member to return to the physician providing the second opinion for any additional treatment. Services, drugs and devices prescribed or recommended as a result of the consultation are not covered unless included as covered under the EOC.

  • Opinion and Negative Assurance Letter of Counsel for the Underwriters The Representatives shall have received on and as of the Closing Date or the Additional Closing Date, as the case may be, an opinion and negative assurance letter of Xxxxxx LLP, counsel for the Underwriters, with respect to such matters as the Representatives may reasonably request, and such counsel shall have received such documents and information as they may reasonably request to enable them to pass upon such matters.

  • Opinion and 10b-5 Statement of Counsel for the Underwriters The Representatives shall have received on and as of the Closing Date or the Additional Closing Date, as the case may be, an opinion and 10b-5 statement of Xxxxx Xxxx & Xxxxxxxx LLP, counsel for the Underwriters, with respect to such matters as the Representatives may reasonably request, and such counsel shall have received such documents and information as they may reasonably request to enable them to pass upon such matters.

  • Opinion and Comfort Letter Furnish, at the request of any Holder requesting registration of Registrable Securities, on the date that such Registrable Securities are delivered to the underwriter(s) for sale, if such securities are being sold through underwriters, or, if such securities are not being sold through underwriters, on the date that the registration statement with respect to such securities becomes effective, (i) an opinion, dated as of such date, of the counsel representing the Company for the purposes of such registration, in form and substance as is customarily given to underwriters in an underwritten public offering and reasonably satisfactory to a majority in interest of the Holders requesting registration, addressed to the underwriters, if any, and to the Holders requesting registration of Registrable Securities and (ii) letters dated as of (x) the effective date of the registration statement covering such Registrable Securities and (y) the closing date of the offering, from the independent certified public accountants of the Company, in form and substance as is customarily given by independent certified public accountants to underwriters in an underwritten public offering and reasonably satisfactory to a majority in interest of the Holders requesting registration, addressed to the underwriters, if any, and to the Holders requesting registration of Registrable Securities.

  • Compliance Certificate and Opinions (a) Upon any application or request by the Company to the Trustee to take any action under any provision of this Indenture, the Company shall, if requested by the Trustee, furnish to the Trustee an Officers’ Certificate stating that all conditions precedent (including covenants compliance with which constitutes a condition precedent), if any, provided for in this Indenture relating to the proposed action have been complied with and an Opinion of Counsel stating that in the opinion of such counsel all such conditions precedent (including covenants compliance with which constitutes a condition precedent), if any, have been complied with. (b) Every certificate or opinion with respect to compliance with a condition or covenant provided for in this Indenture (other than the certificate provided pursuant to Section 10.3) shall include: (i) a statement by each individual signing such certificate or opinion that such individual has read such covenant or condition and the definitions herein relating thereto; (ii) a brief statement as to the nature and scope of the examination or investigation upon which the statements or opinions of such individual contained in such certificate or opinion are based; (iii) a statement that, in the opinion of such individual, he or she has made such examination or investigation as is necessary to enable him or her to express an informed opinion as to whether or not such covenant or condition has been complied with; and (iv) a statement as to whether, in the opinion of such individual, such condition or covenant has been complied with.

  • Opinion and 10b-5 Statement of Counsel for the Initial Purchasers The Representative shall have received on and as of the Closing Date an opinion and 10b-5 statement of Xxxxxxx Xxxxxxx & Xxxxxxxx LLP, counsel for the Initial Purchasers, with respect to such matters as the Representative may reasonably request, and such counsel shall have received such documents and information as they may reasonably request to enable them to pass upon such matters.

  • Certificate and Opinion as to Conditions Precedent Upon any request or application by the Company to the Trustee to take any action under this Indenture, the Company shall furnish to the Trustee: (a) an Officers’ Certificate stating that, in the opinion of the signers, all conditions precedent, if any, provided for in this Indenture relating to the proposed action have been complied with; and (b) an Opinion of Counsel stating that, in the opinion of such counsel, all such conditions precedent have been complied with.

  • Opinion of Counsel to the Obligors A customary favorable written opinion (addressed to the Administrative Agent and the Lenders and dated the Effective Date) of Dechert LLP, New York counsel for the Obligors.

  • Opinion of Counsel, Etc At the Closing, the Purchasers shall have received an opinion of counsel to the Company, dated the date of the Closing, in the form of Exhibit G hereto, and such other certificates and documents as the Purchasers or its counsel shall reasonably require incident to the Closing.

  • Opinion of Counsel to the Underwriters The Representative shall have received an opinion, dated the Closing Date and any Option Closing Date, as the case may be, from Pxxxx Cxxxxxx LLP, securities counsel to the Underwriters, with respect to the Registration Statement, the Prospectus and this Agreement, which opinions shall be satisfactory in all respects to the Representative.

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