Common use of Speech Therapy Benefits Clause in Contracts

Speech Therapy Benefits. Benefits are provided for medically necessary outpatient Speech Therapy services when ordered by a Physician and provided by a licensed speech therapist/pathologist, or other appropriately licensed or certified Health Care Provider pur- suant to a written treatment plan to correct or improve (1) a communication impairment; (2) a swallowing disorder; (3) an expressive or receptive language disorder; or (4) an abnormal delay in speech development. Continued Outpatient Benefits will be provided as long as treatment is Medically Necessary, pursuant to the treatment plan and likely to result in clinically significant progress as measured by objective and standardized tests. The provider's treatment plan and records may be reviewed periodically for Medical Necessity. Except as specified above and as stated under the Home Health Care Benefits and Hospice Program Benefits sections no benefits are provided for Speech Therapy, speech correc- tion, or speech pathology Services. Note: See the Home Health Care Benefits section for infor- mation on coverage for Speech Therapy Services rendered in the home. See the Inpatient Services for Treatment of Illness or Injury section for information on Inpatient Benefits and the Hospice Program Services section.

Speech Therapy Benefits. Benefits are provided for medically necessary outpatient Speech Therapy services when ordered by a Physician and provided by a licensed speech therapist/pathologist, or other appropriately licensed or certified Health Care Provider pur- suant to a written treatment plan to correct or improve (1) a communication impairment; (2) a swallowing disorder; (3) an expressive or receptive language disorder; or (4) an abnormal delay in speech development. Continued Outpatient Benefits will be provided as long as treatment is Medically Necessary, pursuant to the treatment plan plan, and likely to result in clinically significant progress as measured by objective and standardized tests. The provider's treatment plan and records may be reviewed periodically for Medical Necessity. Except as specified above and as stated under the Home Health Care Benefits and Hospice Program Benefits sections sections, no benefits bene- fits are provided for Speech Therapytherapy, speech correc- tioncorrection, or speech pathology Services. Note: See the Home Health Care Benefits section for infor- mation on coverage for Speech Therapy Services rendered in the home. See the Inpatient Services for Treatment of Illness or Injury section for information on Inpatient Benefits and the Hospice Program Services section.