Hospital emergency facility definition

Hospital emergency facility means any hospital facility that offers services for emergency medical conditions as described in s. 632.85 (1) (a), Stats., within its capability to do so and in accordance with s. HFS 124.24, or the licensure require- ments of the jurisdiction in which the hospital resides.

Examples of Hospital emergency facility in a sentence

• You may obtain Emergency Care, including the treatment and stabilization of an emergency medical condition that originated in a Hospital emergency facility or in a comparable facility, from a Participating or non-Participating Providers and the Emergency Care will be covered, based upon the signs and symptoms presented at the time of treatment as documented by the attending health care personnel, whether the Emergency Care services were received within the Service Area or Out-of-Area.

• If post stabilization care is required in a non-Participating Hospital after an Emergency Care condition that originated in a Hospital emergency facility or in a Participating comparable facility (as defined in this paragraph), has been treated and stabilized, the treating Physician or Provider may contact HMO or its designee, but Prior Authorization is not required for post-stabilization care in a non-Participating Hospital.

• In the event that a Covered Person is admitted as an inpatient into a non-preferred facility through an emergency room due to a covered emergency or accident, benefits will be paid at the 80% benefit level for post-stabilization services originating in a Hospital emergency facility or comparable facility.

• Urgent Care services obtained at a Hospital emergency facility may have a maximum benefit limit and/or a higher Copayment.

• In situations when the Health Plan authorizes, refers or otherwise allows a Member access to a Hospital emergency facility or other Urgent Care facility for a medical condition that requires emergency surgery, the Health Plan will reimburse the physician, oral surgeon, periodontist or podiatrist who performed the surgical procedure for any follow-up care that is: 1.

• The value of this work is the same cost that was proposed by the contractor with their original bid submission.

• HMO will pay for a medical screening examination or other evaluation required by Texas or federal law and provided in the emergency department of a Hospital emergency facility, freestanding emergency medical care facility, or comparable emergency facility that is necessary to determine whether an emergency medical condition exists.