Examples of Prior Authorized in a sentence
Prior Authorized Services — In-Plan Services, determined to be Medically Necessary, the utilization of which the PH-MCO manages in accordance with Department-approved Prior Authorization policies and procedures.
All benefits for Durable Medical Equipment (“DME”) includes administration, maintenance and operating costs of such equipment, if the equipment is Medically Necessary or Prior Authorized.
This includes any Prior Authorized Covered Services obtained from a Non-Plan outpatient facility, such as a laboratory, radiological facility (x-ray), or any complex diagnostic or therapeutic services.
Inpatient Hospital Services must be Prior Authorized except when requesting emergency services.
The PH-MCO may waive the Prior Authorization requirements for services which are required by the Department to be Prior Authorized.
Benefits payable for Covered Services which are not Prior Authorized by SHL’s Managed Care Program will be reduced to 50% of what the Insured would have received with Prior Authorization.
Benefits payable for expenses incurred in connection with Covered Services, which are not Prior Authorized by the Managed Care Program, will be reduced as shown in the Attachment A Benefit Schedule.
All transplant procedures must be Prior Authorized for type of transplant and be Medically Necessary and not Experimental or Investigational according to criteria established by Alliant.
Prior Authorized Services — In-Plan Services, the utilization of which the PH- MCO manages in accordance with Department-approved Prior Authorization policies and procedures.
Covered Services include custom-made or custom-fitted Medically Necessary Corrective Appliances when Prior Authorized by HPN’s Managed Care Program, to include the following: Rigid Cervical Collars; Abdominal Binder/Corsets; Shoes when prescribed for a diabetic condition, otherwise only when an integral part of a lower body brace; Helmets when prescribed in connection with cranial orthosis.