Routine Patient Care definition

Routine Patient Care means all health care services consistent with the coverage provided in the policy for the treatment of cancer, including the type and frequency of any diagnostic modality, that is typically covered for a cancer patient who is not enrolled in a Cancer Clinical Trial, and that was not necessitated solely because of the trial.
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Routine Patient Care costs” mean items, drugs and Services: 1. That are typically provided absent a clinical trial; 2. Required solely for the provision of the investigational item or service (such as the administration of a non-covered chemotherapeutic agent), the clinically appropriate monitoring of the effects of the item or service, or the prevention of complications; and 3. Needed for reasonable and necessary care arising from the provision of an investigational item or service, including the diagnosis or treatment of complications. Note: Coverage will not be restricted solely because the Member received the Service outside of the Service Area or the Service was provided by a non-Plan Provider. Off-Label Use of Drugs or Devices We also cover Patient Costs incurred for drugs and devices that have been approved for sale by the FDA whether or not the FDA has approved the drug or device for use in treating the patient’s particular condition, to the extent that the drugs or devices are not paid for by the manufacturer, distributor or provider of that drug or device. See the benefit-specific exclusions immediately below for additional information.
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Routine Patient Care means all health care services consistent with
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Examples of Routine Patient Care in a sentence

  • Routine patient care is care that would otherwise be covered by the plan if those services were not provided in connection with an approved clinical trial.

  • Routine patient care costs for qualifying clinical trials include: • Covered Health Care Services for which Benefits are typically provided absent a clinical trial.

  • Routine patient care costs incurred while taking part in a qualifying clinical trial for the treatment of: • Cancer or other life-threatening disease or condition.

  • Routine patient care costs include the costs associated with the provision of health care services, including drugs, items, devices, and services that would otherwise be covered under the plan or contract if those drugs, items, devices, and services were not provided in connection with an approved clinical trial program, including: • Health care services typically provided absent a clinical trial.

  • Routine patient care costs do not include the costs associated with the provision of any of the following: • Drugs or devices that have not been approved by the federal Food and Drug Administration and that are associated with the clinical trial.

  • Routine patient care costs for patients diagnosed with cancer who are accepted into phase I, II, III, or IV clinical trials are covered when Medically Necessary, recommended by the Member's treating Physician and authorized by Health Net.

  • SAMPLE Routine patient care costs for qualifying clinical trials include: • Covered Health Care Services for which Benefits are typically provided absent a clinical trial.

  • Routine patient care costs for items and services furnished in connection with participating in an approved clinical trial are covered when Medically Necessary, authorized by Health Net, and either the Member’s treating Physician has recommended participation in the trial or the Member has provided medical and scientific information establishing eligibility for the clinical trial.

  • Routine patient care costs incurred during participation in a qualifying clinical trial for the treatment of: • Cancer or other life-threatening disease or condition.

  • Routine patient care costs, for purposes of this Agreement, is defined as those costs associated with the provision of health care services, including drugs, items, devices, and services that would otherwise be covered under the plan or contract if those drugs, items, devices, and services were not provided in connection with an approved cancer clinical trial program, including the following: Health care services covered absent a cancer clinical trial.


More Definitions of Routine Patient Care

Routine Patient Care means all health care services consistent with the coverage provided in the health benefit plan or public employee benefit plan for the treatment of cancer, including
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Routine Patient Care means all health care services
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Related to Routine Patient Care

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

  • 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.

  • Direct Patient Care means the provision of health care services provided directly to individuals being treated for or suspected of having physical or mental illnesses. Direct patient care includes both, face-to-face and telehealth-based preventative care and first-line supervision.

  • Urgent Care means treatment for a condition that is not a threat to life or limb but does require prompt medical attention. Also, the severity of an urgent condition does not necessitate a trip to the hospital emergency room. An Urgent Care facility is a freestanding facility that is not a physician’s office and which provides Urgent Care.