Examples of Hospital level of care in a sentence
However, all services are subject to the provisions in the section entitled Concurrent Review.If The Plan determines that the Member’s treatment does not require Inpatient or partial Hospital level of care, the Member and the Member’s provider will be notified of that decision.
If the Member proceeds with an Inpatient stay or partial Hospital level of care, without The Plan's approval, the Member may be responsible to pay the full cost of the services received.If the Member, his/her Physician, or other appropriate party, as identified above, does not request Prior Authorization, The Plan will conduct a retrospective review after the claims have been submitted.
Acute Hospital Administrative Day rates will be paid in accordance with Section 5.B.6 for all days that a patient remains in the Rehabilitation Unit while not at Hospital level of care.
CANS-NY HCBS eligibility algorithm is based on a subset of the CANS-NY questions or items and has been used for assessing individual improvement, identification of service needs, determination of NF and Hospital level of care, treatment planning, assessing the quality of services, and providing feedback regarding system functioning.
Performance Measure:Number and percent of newly enrolled waiver consumers who have a need for a State Psychiatric Hospital level of care (LOC) prior to receipt of services.
Numerator: Number of newly enrolled waiver consumers who have received a State Psychiatric Hospital level of care (LOC) prior to receipt of services.
If the Member proceeds with an Inpatient stay or partial Hospital level of care, without The Plan's approval, the Member may be responsible to pay the full cost of the services received.28If the Member, his/her Physician, or other appropriate party, as identified above, does not request Prior Authorization, The Plan will conduct a retrospective review after the claims have been submitted.
However, all services are subject to the provisions in the section entitled Concurrent Review.28If The Plan determines that the Member’s treatment does not require Inpatient or partial Hospital level of care, the Member and the Member’s provider will be notified of that decision.
The individual has demonstrated an inability to maintain a healthy weight and/or medical stability without the frequency and intensity of structured interventions of the Eating Disorder Partial Hospital level of care.
Acute Hospital Administrative Day rates will be paid in accordance with Section 5.B.11 for all days that a patient remains in the Rehabilitation Unit while not at Hospital level of care.