Examples of Qualified Member in a sentence
Benefits will be provided for the medical equipment and monitoring services provided to a Qualified Member with a chronic condition or disease in conjunction with the EMP for maintenance of the Qualified Member’s chronic condition or disease.
Benefits will be provided for a review by a team of Specialists of a Qualified Member’s medical records where the Qualified Member has a complex or rare condition or multiple conditions or diseases for which the course of treatment requires unique expertise.
Chronic Care Coordination Program (CCC Program) means the assessment and coordination of primary care services to a Qualified Member with multiple chronic and severe health conditions.
Benefits will be provided for a pharmacist’s review of medications and consultation with the Qualified Member to improve the effectiveness of pharmaceutical therapy.
Complex Case Management Program (CCM Program) means the assessment and coordination of specialty services provided to a Qualified Member with advanced or critical illnesses.