Medically necessary health care definition

Medically necessary health care means health care services or products provided to an enrollee for the purpose of preventing, diagnosing or treating an illness, injury or disease or the symptoms of an illness, injury or disease in a manner that is:
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Medically necessary health care means health care services or products provided to an enrollee for the purpose of preventing, diagnosing or treating an illness, Injury or disease
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Examples of Medically necessary health care in a sentence

  • Medically necessary health care services, including equipment and supplies, that are prescribed by your provider for the management and treatment of type I diabetes, type II diabetes, and/or gestational diabetes.

  • This indicates that the misalignment of the MVGs was one of the major error sources in the first set of CFD models.

  • Medically necessary health care services or products, including those 2 4 medical, dental, vision, behavioral, home health, and other health care services to which Members are entitled under the Program as described in the Request for Proposal and contract between LHS and HSD.

  • Medically necessary health care services must be obtained through the providers in AmeriHealth Caritas Ohio’s provider network.

  • Medically necessary: health care services that are in accordance with generally accepted evidence based medical standards or that are considered by most physicians within the community of their respective professional standards of care.

  • Medically Necessary Definition Medically necessary health care services or supplies are medically appropriate and:• Necessary to meet members’ basic health needs.• Cost-efficient and appropriate for the covered services.

  • Medically necessary health care services will be administered throughout the referral process with the Alliance, regardless of whether or not the child is accepted into the CCS program (e.g. Early and Periodic Screening, Diagnosis and Treatment (EPSDT) services for Medi-Cal members).

  • Medically necessary health care includes treatment related to chronic or pre-existing conditions, unless the express purpose of travel to Croatia is to obtain treatment (such as high blood pressure control), as well as health care related to pregnancy and childbirth, unless the express purpose of stay in Croatia is childbirth.

  • Medically necessary health care, including diagnostic services and treatment, which are reimbursable pursuant to 42 U.S.C. § 1396d, and which are not otherwise reimburs- able under the Wyoming Medicaid State Plan.

Related to Medically necessary health care

  • Medically necessary care means care that is (1) appropriate and consistent with and essential for the prevention, diagnosis, or treatment of a Patient’s condition; (2) the most appropriate supply or level of service for the Patient’s condition that can be provided safely; (3) not provided primarily

  • Medically Necessary means a service which is appropriate and consistent with the treatment of the condition in accordance with accepted standards of community practice.

  • Medically Necessary Services means those covered services that are, under the terms and conditions of the contract, determined through contractor utilization management to be:

  • Medically Necessary Treatment means any treatment, tests, medication, or stay in hospital or part of a stay in hospital which:

  • Licensed health care practitioner means a physician, as defined in Section 1861(r)(1) of the Social Security Act, a registered professional nurse, licensed social worker or other individual who meets requirements prescribed by the Secretary of the Treasury.

  • Home Health Care means the continual care and treatment of an individual if:

  • Health care worker means a person other than a health care professional who provides medical, dental, or other health-related care or treatment under the direction of a health care professional with the authority to direct that individual's activities, including medical technicians, medical assistants, dental assistants, orderlies, aides, and individuals acting in similar capacities.

  • Licensed health care professional means a person who possesses a professional medical license that is valid in Oregon. Examples include, but are not limited to, a registered nurse (RN), nurse practitioner (NP), licensed practical nurse (LPN), medical doctor (MD), osteopathic physician (DO), respiratory therapist (RT), physical therapist (PT), physician assistant (PA), or occupational therapist (OT).

  • Community mental health program means all mental health

  • Respiratory care practitioner means an individual who practices respiratory care.

  • Health care practitioner means an individual licensed

  • Medically fragile means the condition of a child who requires the availability of twenty-four-hour skilled care from a health care professional or specially trained staff or volunteers in a group care setting. These conditions may be present all the time or frequently occurring. If the technology, support and services being received by the medically fragile children are interrupted or denied, the child may, without immediate health care intervention, experience death.

  • Licensed health care provider means a physician, physician assistant, chiropractor, advanced registered nurse practitioner, nurse, physical therapist, or athletic trainer licensed by a board.

  • Health care plan means any contract, policy or other arrangement for benefits or services for medical or dental care or treatment under:

  • Managed health care system means: (a) Any health care

  • Allied Health Professional means a person registered as an allied health professional with the Health Professions Council;

  • Health care means any of the following intended for use in the diagnosis, treatment, mitigation, or prevention of a human ailment or impairment:

  • Home health aide services means the personal care and maintenance activities provided to individuals for the purpose of promoting normal standards of health and hygiene.

  • Home health aide means an individual employed by a home health agency to provide home health services under the direction of a registered nurse or therapist.

  • Behavioral health treatment means counseling and treatment programs, including applied behavior analysis, that are:

  • Mental health therapist means the same as that term is defined in Section 58-60-102.

  • Behavioral health administration or "BHA" means

  • Health care professional means a physician or other health care practitioner licensed, accredited or certified to perform specified health care services consistent with state law.

  • Health care system means any public or private entity whose function or purpose is the management of, processing of, enrollment of individuals for or payment for, in full or in part, health care services or health care data or health care information for its participants;

  • Behavioral health provider means a person licensed under 34 chapter 18.57, 18.57A, 18.71, 18.71A, 18.83, 18.205, 18.225, or 18.79

  • Community mental health center or "CMHC" means a facility offering a comprehensive array of community-based mental health services, including but not limited to, inpatient treatment, outpatient treatment, partial hospitalization, emergency care, consultation and education; and, certain services at the option of the center, including, but not limited to, prescreening, rehabilitation services, pre-care and aftercare, training programs, and research and evaluation.