Medically Necessary or Medical Necessity definition

Medically Necessary or Medical Necessity means a treatment, service or supply that is:

Medically Necessary or Medical Necessity means services or supplies which, under the provisions of this Agreement, are determined to be:

Medically Necessary or Medical Necessity means services or supplies which are:

Examples of Medically Necessary or Medical Necessity in a sentence

• Medically Necessary or Medical Necessity means those services or supplies covered under the Plan which are: 1.

• Medically Necessary or Medical Necessity means health care services or supplies that a health care provider, exercising clinical judgment, renders to or recommends for a patient for the purpose of preventing, evaluating, diagnosing or treating an illness, injury, disease, or its symptoms.

• Medically Necessary or Medical Necessity means those services or supplies covered under the Plan which are:1.

• Medically Necessary or Medical Necessity means health care services or supplies that a Health Care Provider, exercising prudent clinical judgment, renders to or recommends for, a patient for the purpose of preventing, evaluating, diagnosing or treating an illness, injury, disease or its symptoms.

• Medically Necessary or Medical Necessity means health care services that a Physician, exercising prudent clinical judgment, would provide to an Insured Person for the purpose of preventing, evaluating, diagnosing or treating an illness, injury, disease or its symptoms, and that are:1.

More Definitions of Medically Necessary or Medical Necessity

Medically Necessary or Medical Necessity means, with respect to the provision of medical services, supplies and drugs: (a) required by a Member; (b) provided in accordance with recognized professional medical and surgical practices and standards; (c) appropriate and necessary for the symptoms, diagnosis, or treatment of the Member’s medical condition; (d) provided for the diagnosis and direct care and treatment of such medical condition; (e) not furnished primarily for the convenience of the Member, the Member’s family, or the treating provider or other provider; (f) furnished at the most appropriate level that can be provided consistent with generally accepted medical standards of care; and (g) consistent with Blue Shield Medical Policy.

Medically Necessary or Medical Necessity means, with respect to the provision of medical services, supplies and drugs: (a) required by a Member; (b) provided in accordance with recognized professional medical and surgical practices and standards; (c) appropriate and necessary for the symptoms, diagnosis, or treatment of the Member’s medical condition; (d) provided for the diagnosis and direct care and treatment of such medical condition; (e) not furnished primarily for the convenience of the Member, the Member’s family, or the treating provider or other provider; (f) furnished at the most appropriate level that can be provided consistent with generally accepted medical standards of care; and (g) consistent with Blue Shield Medical Policy and Blue Shield Medication Policy.

Medically Necessary or Medical Necessity means health care services that a Physician, exercising prudent clinical judgement, would provide to a patient for the purpose of preventing, evaluating, diagnosing or treating an Illness, Injury, disease or its symptoms, and that are:

Medically Necessary or Medical Necessity means health care services, supplies or treatment which, in the judgment of the attending Physician, is appropriate and consistent with the diagnosis and which, in accordance with generally accepted medical standards, could not have been omitted without adversely affecting the Covered Person's condition or the quality of medical care provided.

Medically Necessary or Medical Necessity means services or supplies which under the terms and conditions of this Agreement, are determined to be:

Medically Necessary or Medical Necessity means, with respect to the provision of medical services, supplies and drugs: (a) required by a Member; (b) provided in accordance with recognized professional medical and surgical practices and standards; (c) appropriate and necessary for the symptoms, diagnosis, or treatment of the Member’s medical condition; (d) provided for the diagnosis and direct care and treatment of such medical condition; (e) not furnished primarily for the convenience of the Member, the Member’s family, or the treating provider or other provider; (f) furnished at the most appropriate level that can be provided consistent with generally accepted medical standards of care; and (g) consistent with Blue Shield Medical Policy and Blue Shield Medication Policy. Allied & Ancillary Provider Model Agreement v23 rev 12-10-18.docx Base 03-03-16 Proprietary and Confidential – Blue Shield of California

Medically Necessary or Medical Necessity means the services or supplies provided by a hospital, Physician, or other licensed provider that are required to identify or treat the Covered Person’s Illness or Injury and which, as determined by Us, are: 1) consistent with the symptoms or diagnosis and treatment of the Covered Person’s condition, disease, Illness, ailment or Injury;