Examples of Urgent Services in a sentence
Services, which could include Medically Necessary Services, that are not considered Urgent Services.
If you receive Emergency or Urgent Services from a Non-Participating Provider, you may be required to pay the charges in full and submit a claim to Blue Shield to request reimbursement.
See the Out-of-area services section in the Other important information about your plan section for more information on claims for Emergency or Urgent Services outside of California.
Urgent Services are services (other than Emergency Services) which are Medically Necessary to prevent serious deterioration of a Member's health, alleviate severe pain, or treat an illness or injury with respect to which treatment cannot reasonably be delayed.
Except for Emergency Services, Urgent Services, and services received at a Participating Hospital under certain conditions, this plan does not cover services from Non- Participating Providers.
Out-of-Area Covered Health Care Services are restricted to Emergency Services, Urgent Services, and Out-of-Area Follow-up Care.
Members are entitled to receive Urgent Services, including Urgent Services received outside the Health Plan’s service area, when such services are Medically Necessary to prevent serious deterioration of a Member's health, alleviate severe pain, or treat an illness or injury with respect to which treatment cannot reasonably be delayed.
If a Member chooses to obtain out-of-network Chiropractic Services or Acupuncture Services (other than Urgent Services) from a provider other than a Participating Provider, the Member will be liable for payment for such services.
Members enrolled in this Trio HMO Health Plan may only obtain Covered Services from Primary Care Physicians and Medical Group/IPAs designated as Plan Providers in the Blue Shield Trio HMO Health Plan Physician and Hospital Directory, except for Emergency Services or Urgent Services when the Member is out of the Service Area.
Services (other than Urgent Services) performed by a Provider who is a family member by birth or marriage, including spouse, brother, sister, parent or child are not covered.