Inpatient Covered Services definition

Inpatient Covered Services means Covered Services provided by a Participating Hospital to a Member who is admitted and treated as a registered inpatient, is assigned a licensed bed within the Hospital, remains assigned to such bed and for whom a room and board charge is made.
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Examples of Inpatient Covered Services in a sentence

  • For Inpatient Covered Services received from a Non-Participating Provider, you will be responsible for the first $500 should you fail to notify Blue Cross and Blue Shield in addition to any Deductibles, Copayments and/or Coinsurance applicable to this Certificate.

  • Inpatient Covered Services for Detoxification shall be covered for seven (7) days per admission for Detoxification with a Lifetime Maximum of four (4) admissions for Detoxification per Covered Person.

  • For Inpatient Covered Services received from a Non-Participating Provider, you will be responsible for the first $500 should you fail to notify Blue Cross and Blue Shield in addition to any Deductibles, Copayments and/or Coinsurance applicable to this Policy.

  • Inpatient Covered Services may require Preauthorization by the Plan before services are provided; provided however, that no Preauthorization is required for (1) forty-eight (48) hours of Inpatient care following a vaginal delivery or ninety-six (96) hours of Inpatient care following a Cesarean section or (2) Post-Partum Care.

  • Inpatient Covered Services for eligible Participants upon confinement in a Residential Treatment Facility must be based on an Individual Treatment Plan prescribed by the attending Physician and approved by the Carrier’s Medical Director.

  • In the event that HCT should become insolvent, Group agrees to provide Covered Services to each Member until the sooner of: (i) the expiration of the period for which a Member’s premiums have been paid to HCT and, in the case of a Member receiving Inpatient Covered Services at the Group at the time of such expiration, until the time of discharge from the Group; or (ii) until the Member becomes covered under another health insurance plan with similar benefits.

  • For inpatient admissions for Members who are transferred out of FACILITY to another facility for purposes of providing Inpatient Covered Services, ANTHEM shall reimburse FACILITY the lesser of DRG Rate or the Outlier Rate as specified on the Rate Sheet.

  • When authorized by the CO-OP’s Behavioral Health/Substance Abuse Provider, Covered Services include evaluation, crisis intervention or psychotherapy only. Inpatient: Covered Services for the diagnosis and treatment of a Mental Illness. Outpatient: Outpatient evaluation and treatment of Mental Illness including individual and group psychotherapy sessions.

  • The Contractor shall be responsible for payment of Inpatient Covered Services for Children in Xxxxxx Care.

  • When you receive Inpatient Covered Services from a Non- Participating Provider or in a Plan Program of a Non- Participating Provider, benefits will be provided at the Hospital payment level for Non- Participating Providers shown on the Schedule Page.

Related to Inpatient Covered Services

  • Covered Services means all or a part of those medical and health services set forth in rule 441—86.14(514I).

  • Non-Covered Services means those vision care services which are not Covered Services under Plan Contract(s).

  • Inpatient care means treatment for which the insured person has to stay in a hospital for more than 24 hours for a covered event.

  • Inpatient means an Insured Person who is Confined.

  • Covered service means a health care service provided to a

  • Routine patient care costs means Covered Medical Expenses which are typically provided absent a clinical trial and not otherwise excluded under the Policy. Routine patient care costs do not include:

  • Inpatient services means services provided to you as an admitted inpatient in a recognised private or public hospital for treatment that is in an included clinical category, has a Medicare item number allocated and a Medicare benefit is payable.

  • Inpatient hospital services means any health care service provided to a patient who has been admitted to a hospital and is required to remain in that hospital overnight, but does not include any secure forensic mental health services;

  • Finished Services means complete end-to-end services offered by Qwest to wholesale customers or retail End User Customers. Finished Services do not include Unbundled Network Elements or combinations of Unbundled Network Elements. Finished Services include Access Services, private lines, retail services, and resold services.

  • Outpatient hospital services means preventive, diagnostic, therapeutic, observation, rehabilitation, or palliative services provided to an outpatient by or under the direction of a physician, dentist, or other practitioner by an institution that:

  • Outpatient means a person who is receiving care other than on an inpatient basis, such as: • in a provider’s office; • in an ambulatory surgical center or facility; • in an emergency room; or • in a clinic. .

  • Outpatient attendance means treatment received in a hospital emergency department where the patient is not admitted to a bed in the hospital.

  • Outpatient services means those services rendered in a practitioner’s office or in the department of an approved facility where services are rendered to persons who have not had an overnight stay and are not charged for room and board.

  • Shared Services means shared order filling or shared order processing, or both.

  • Routine Patient Costs means all health care services that are otherwise covered under the Group Contract for the treatment of cancer or other Life-threatening Condition that is typically covered for a patient who is not enrolled in an Approved Clinical Trial.

  • Long-term inpatient care means inpatient services for

  • Medical Expenses means those expenses that an Insured Person has necessarily and actually incurred for medical treatment on account of Illness or Accident on the advice of a Medical Practitioner, as long as these are no more than would have been payable if the Insured Person had not been insured and no more than other hospitals or doctors in the same locality would have charged for the same medical treatment.

  • Medical Expense means an expense incurred at the time a past member or his or her health reimbursement account dependent is furnished the medical care or service. To be considered a medical expense under this act, the expense shall meet all of the following conditions:

  • Urgently Needed Services means Covered Services needed to prevent a serious deterioration in a Member’s health. While not as immediate as Emergency Services, these services cannot be delayed until the Member can see a Plan Provider.

  • Dependent care assistance program or "DCAP" means a benefit plan whereby school employees may pay for certain employment related dependent care with pretax dollars as provided in the salary reduction plan under chapter 41.05 RCW pursuant to 26 U.S.C. Sec. 129 or other sections of the Internal Revenue Code.

  • Enrollee point-of-service cost-sharing or "cost-sharing" means amounts paid to health carriers directly providing services, health care providers, or health care facilities by enrollees and may include copayments, coinsurance, or deductibles.

  • Medical personnel means those persons assigned, by a Party to the conflict, exclusively to the medical purposes enumerated under sub-paragraph (e) or to the administration of medical units or to the operation or administration of medical transports. Such assignments may be either permanent or temporary. The term includes:

  • Advanced Services refers to high speed, switched, broadband, wireline Telecommunications capability that enables users to originate and receive high-quality, voice, data, graphics or video Telecommunications using any technology.

  • Hospice patient s family" means a hospice patient's immediate family members, including a spouse, brother, sister, child, or parent, and any other relative or individual who has significant personal ties to the patient and who is designated as a member of the patient's family by mutual agreement of the patient, the relative or individual, and the patient's interdisciplinary team.

  • Planned Service Interruption means a Service Interruption that has been scheduled to occur in accordance with Schedule 5;

  • PREVENTIVE CARE SERVICES means covered healthcare services performed to prevent the occurrence of disease as defined by the Affordable Care Act (ACA). See Preventive Care and Early Detection Services in Section 3. PRIMARY CARE PROVIDER (PCP) means, for the purpose of this plan, professional providers that are family practitioners, internists, and pediatricians. For the purpose of this plan, gynecologists, obstetricians, nurse practitioners, and physician assistants may be credentialed as PCPs. To find a PCP or check that your provider is a PCP, please use the “Find a Doctor” tool on our website or call Customer Service.