Emergency Case definition

Emergency Case means medical services are necessary to treat a condition or illness that, without immediate medical attention, would either (i) seriously jeopardize the life or health of the Member or the Member’s ability to regain maximum function, or (ii) cause the Member to be in danger to self or others.

Emergency Case means: (a) an adverse decision is rendered for a dental service or procedure that is proposed but has not been delivered; and (b) the dental service or procedure is necessary to treat a condition or illness that, without immediate medical attention, would seriously jeopardize Your life or health or Your to regain maximum function, or cause You to be in danger to self or others.

Emergency Case means an urgent case; "facility" means health care facility;

Examples of Emergency Case in a sentence

• An expedited review of an Emergency Case may be initiated by calling 1-404-364-4862 or TTY/TDD 1-800-255-0056.Once an expedited review is initiated, a clinical review will determine whether you have a medical condition that meets the definition of an Emergency Case.

• Note: In cases in which a complaint is filed with the Commissioner, you or your Authorized Representative must authorize the release of medical records to the Commissioner to assist with reaching a decision in the complaint.Expedited Grievances for Emergency CasesYou or your Authorized Representative may seek an expedited review in the event of an Emergency Case as that term is defined for this section.

• An expedited review of an Emergency Case may be initiated by calling 1-800-777-7902.Once an expedited review is initiated, a clinical review will determine whether you have a medical condition that meets the definition of an Emergency Case.

• If you have an Emergency Case, then a request for concurrent review will be handled like any other pre-service request for review when an Emergency Case is involved, except that our decision will be made within one (1) working day.If Health Plan authorizes an extended stay or additional health care Services under the concurrent review, the Health Plan will:1.

• Expedited Grievances for Emergency CasesYou or your Authorized Representative may seek an expedited review in the event of an Emergency Case as that term is defined for this section.

More Definitions of Emergency Case

Emergency Case. A case in which an Adverse Decision was rendered pertaining to Health Care Services which have yet to be delivered and such Health Care Services are necessary to treat a condition or illness

Emergency Case means a situation where significant financial loss may occur or may result to serious disruption to business;

Emergency Case means a case involving an adverse decision for which an expedited review is required if:

Emergency Case means a case that qualifies for an expedited review because:

Emergency Case. Emergency medical treatment required based on the beneficiary’s medical case, as a result of accident, occasional event or emergency health case requiring rapid medical intervention, as per the following ةلاحلا هيضتقت يذلا ئراطلا يبطلا جلاعلا :ةئراطلا ةلاحلا 1.20 ةلاح وأ ضراع وأ ،ثدح عوقو رثإ ديفتسملل ةيبطلا بسح عيرسلا يبطلا لخدتلا يعدتست ةئراط ةيحص تايوتسم نم ).ئراوطلا -2 .شاعنلإا -1( ةيلاتلا تايوتسلما levels (1. resuscitation. 2. Emergency.) of the levels of urgent medical care, as outlined in Private Health Institutions Law and Its Executive Regulations, approved by the Ministry of Health, set to screen emergencies. تاسسؤلما ماظنب حضوم وه امك ةلجاعلا ةيبطلا ةياعرلا ةرازو نم ةدمتعلما ةيذيفنتلا هتحئلاو ةصاخلا ةيحصلا .ةئراطلا تلااحلا زرف ددحي يذلاو ةحصلا

Emergency Case means unplanned Confinement resulting from an acute Illness or Accident provided that the initial sign and symptom of an acute Illness or the occurrence of an Accident and the relevant consultation or treatment are not separated by more than forty-eight (48) hours.

Emergency Case. A case in which an Adverse Decision was rendered pertaining to Health Care Services which have yet to be delivered and such Health Care Services are necessary to treat a condition or illness that, without medical attention would: (a) seriously jeopardize the life or health of the Member or the Member’s ability to regain maximum function; or (b) cause the Member to be in danger to self or others. Grievance: A protest filed by a Member with Health Plan through our internal grievance process regarding an Adverse Decision concerning the Member. A Grievance does not include a verbal request for reconsideration of a Utilization Review determination.