REQUIRED SECOND SURGICAL OPINION Sample Clauses

REQUIRED SECOND SURGICAL OPINION. If a surgeon has recom- mended that an Insured undergo any non-emergency surgical procedure, the Insured must notify USA Medical Services at least seventy-two (72) hours prior to the scheduled pro- cedure. If a second surgical opinion is deemed necessary by either the Insurer or USA Medical Services, it must be conducted by a physician chosen and arranged by USA Medical Services. Only those second surgical opinions required and coordinated by USA Medical Services are covered. In the event the second surgical opinion contradicts or does not confirm the need for surgery, the Insurer will also pay for a third surgical opinion from a physician chosen by USA Medical Services. If the second or third sur- gical opinion confirms the need for surgery, benefits for the surgery will be paid according to this policy. IF THE INSURED DOES NOT OBTAIN A REQUIRED SECOND SURGICAL OPINION, THE INSURED WILL BE RESPONSIBLE FOR THIRTY PER- CENT (30%) OF ALL COVERED MEDICAL AND HOSPITAL CHARGES RELATED TO THE CLAIM IN ADDI- TION TO THE PLAN DEDUCT- IBLE AND COINSURANCE (IF APPLICABLE).
Sample 1Sample 2Sample 3See All (22)
AutoNDA by SimpleDocs
REQUIRED SECOND SURGICAL OPINION. If a surgeon has recommended a non-emer- gency surgical procedure, the insured must notify USA Medical Services at least seventy-two (72) hours prior to the scheduled procedure. If a second surgical opinion is deemed necessary by either the insurer or USA Medical Services, it must be conducted by a physician chosen and arranged by USA Medical Services. Only those second surgical opinions required and coordinated by USA Medical Services are covered. In the event the second surgical opinion contradicts or does not confirm the need for surgery, the insurer will also pay for a third surgical opinion from a physician chosen in agreement between the insured and USA Medical Services. If the second or third surgical opinion confirms the need for surgery, benefits for the surgery will be paid according to this policy. IF THE INSURED DOES NOT OBTAIN A REQUIRED SECOND SURGICAL OPINION, THE INSURED WILL BE RESPONSIBLE FOR THIRTY PERCENT (30%) OF ALL COVERED MEDICAL AND HOSPITAL CHARGES RELATED TO THE CLAIM, IN ADDITION TO THE PLAN DEDUCTIBLE.
Sample 1Sample 2Sample 3See All (17)
REQUIRED SECOND SURGICAL OPINION. If a surgeon has recommended that an Insured undergo any non-emergency surgical procedure, the Insured must notify Redbridge Network & Healthcare, Inc at least seventy-two (72) hours prior to the scheduled procedure. If a second surgical opinion is deemed necessary by either the Insurer or Redbridge Network & Healthcare, Inc, it must be conducted by a physician chosen and arranged by Redbridge Network & Healthcare, Inc. Only those second surgical opinions required and coordinated by Redbridge Network & Healthcare, Inc are covered. In the event the second surgical opinion contradicts or does not confirm the need for surgery, the Insurer will also pay for a third surgical opinion from a physician chosen by Redbridge Network & Healthcare, Inc. If the second or third surgical opinion confirms the need for surgery, benefits for the surgery will be paid according to this policy. IF THE INSURED DOES NOT OBTAIN A REQUIRED SECOND SURGICAL OPINION, THE INSURED WILL BE RESPONSIBLE FOR THIRTY PERCENT (30%) OF ALL COVERED MEDICAL AND HOSPITAL CHARGES RELATED TO THE CLAIM IN ADDITION TO THE PLAN DEDUCTIBLE AND COINSURANCE. (IF APPLICABLE).
Sample 1Sample 2See All (5)
REQUIRED SECOND SURGICAL OPINION. If a surgeon has recommended that an Insured undergo any non-emergency surgical procedure, the Insured must notify Assuria Medische Verzekering N.V. or the Service Administrator at least seventy-two (72) hours prior to the scheduled procedure. If a second surgical opinion is deemed necessary by either the Insurer or Assuria Medische Verzekering N.V. or the Service Administrator, it must be conducted by a surgeon chosen and arranged by Assuria Medische Verzekering N.V. or the Service Administrator. Only those second surgical opinions required and coordinated by Assuria Medische Verzekering N.V. or the Service Administrator are covered. In the event the second surgical opinion contradicts or does not confirm the need for surgery, the Insurer will also pay for a third surgical opinion from a surgeon chosen by Assuria Medische Verzekering N.V. or the Service Administrator. If the second or third surgical opinion confirms the need for surgery, benefits for the surgery will be paid according to this policy. IF THE INSURED DOES NOT OBTAIN A REQUIRED SECOND OR THIRD SURGICAL OPINION, THE INSURED WILL BE RESPONSIBLE FOR THIRTY PERCENT (30%) OF ALL COVERED MEDICAL AND HOSPITAL CHARGES RELATED TO THE CLAIM IN ADDITION TO THE PLAN DEDUCTIBLE 15.OUTPATIENT SERVICES: Coverage is only provided when medically necessary.
Sample 1
REQUIRED SECOND SURGICAL OPINION. We may require a second opinion before We preauthorize a surgical procedure. There is no cost to You when We request a second opinion. • The second opinion must be given by a board certified Specialist who personally examines You. • If the first and second opinions do not agree, You may obtain a third opinion. • The second and third opinion consultants may not perform the surgery on You.
Sample 1

Related to REQUIRED SECOND SURGICAL OPINION

  • Notice to Union of Long Term Layoff In the event of a pending layoff of a permanent or long-term nature, the Home will:

  • PROJECT REPRESENTATION BEYOND BASIC SERVICES 1.2.1. The State may at its option secure the services of a person or persons known as a Clerk-of-the-Works, referred to herein as a "Clerk". The Clerk(s) shall, for all purposes of this Agreement, report and be solely responsible to the State. The State may at any time dismiss the Clerk(s) for cause or convenience; however, any such action shall not affect the State's and ARCHITECT/ENGINEER'S obligations under this Agreement. In such event, the State shall use their best efforts to secure the services of a Clerk or Clerks under this paragraph as soon as is practicable if the State deems it necessary.

  • CONDITION SUBSEQUENT/NON-APPROPRIATION OF FUNDING The compensation paid to CONTRACTOR pursuant to this Agreement is based on COUNTY’S continued appropriation of funding for the purpose of this Agreement, as well as the receipt of local, county, state and/or federal funding for this purpose. The parties acknowledge that the nature of government finance is unpredictable, and that the rights and obligations set forth in this Agreement are therefore contingent upon the receipt and/or appropriation of the necessary funds. In the event that funding is terminated, in whole or in part, for any reason, at any time, this Agreement and all obligations of the COUNTY arising from this Agreement shall be immediately discharged. COUNTY agrees to inform CONTRACTOR no later than ten (10) calendar days after the COUNTY determines, in its sole judgment, that funding will be terminated and the final date for which funding will be available. Under these circumstances, all billing or other claims for compensation or reimbursement by CONTRACTOR arising out of performance of this Agreement must be submitted to COUNTY prior to the final date for which funding is available. In the alternative, COUNTY and CONTRACTOR may agree, in such circumstance, to a suspension or modification of either party's rights and obligations under this Agreement. Such a modification, if the parties agree thereto, may permit a restoration of previous contract terms in the event funding is reinstated. Also in the alternative, the COUNTY may, if funding is provided to the COUNTY in the form of promises to pay at a later date, whether referred to as “government warrants,” “IOUs,” or by any other name, the COUNTY may, in its sole discretion, provide similar promises to pay to the CONTRACTOR, which the CONTRACTOR hereby agrees to accept as sufficient payment until cash funding becomes available.

  • E T W E E N [ ] of [ ] (“the Trust”) which expression shall include its permitted successors and assigns; and [ ] of [ ] (“the Provider”) which expression shall include its permitted successors and assigns.

  • Lodgement of SWS wage assessment agreement C.6.1 All SWS wage assessment agreements under the conditions of this schedule, including the appropriate percentage of the relevant minimum wage to be paid to the employee, must be lodged by the employer with Fair Work Australia.

Time is Money Join Law Insider Premium to draft better contracts faster.