Covered Services definition

Covered Services means all or a part of those medical and health services set forth in rule 441—86.14(514I).

Covered Services means Medically Necessary health care items and services covered under a Benefit Plan.

Covered Services means those health care services for which Members are entitled to receive benefits, including reimbursement, under the terms of the applicable Plan.

Examples of Covered Services in a sentence

• Participating Providers shall render Covered Services in a manner that does not discriminate based upon race, color, national origin, ancestry, religion, sex, age, marital status, sexual orientation, veteran status, other illegal basis or the source of payment.

• Employer shall deliver to Ascension a list of Covered Members eligible to receive Covered Services under this Agreement.

• Such digital therapy products, even though such products are Non-ACO Covered Services, must be listed on Contractor’s formulary in the same manner as listed on the MassHealth Drug List, with the same prior authorization status, point of sale (POS) rules, age restrictions, step therapy, quantity limit and diagnostic restrictions as MassHealth FFS.

• Ascension shall require Participating Providers to provide or arrange for the provision of Covered Services to Covered Individuals those services as outlined by the Program.

• Consider, for example, a provider that furnishes and receives payment for Covered Services, but fails to meet some performance standard relating to those services, such as a certain score on quality measures.

More Definitions of Covered Services

Covered Services means medically necessary mental health and substance abuse care as defined under the terms of the Program, except to the extent that such care is otherwise limited or excluded under the Program.

Covered Services means the services, supplies, or accommodations for which the Plan provides Benefits.

Covered Services means those health care services which are (i) identified as payable in Certificate(s), (ii) medically necessary as defined in such Certificates, and (iii) ordered and performed by a TRUST PRACTITIONER or other health care PRACTITIONER licensed to order and perform such services.

Covered Services means, except as otherwise provided in the Member’s benefit plan, a complete and routine eye examination including, but not limited to, visual acuities, internal and external examination, (including dilation where professionally indicated,) refraction, binocular function testing, tonometry, neurological integrity, biomicroscopy, keratometry, diagnosis and treatment plan, and when authorized by state law and covered by a Plan, medical eye care, diagnosis, treatment and eye care management services, and when applicable, ordering and dispensing plan eyeglasses from a DAVIS laboratory.

Covered Services means services for which reimbursement

Covered Services means those medical, surgical and related health care services which Practice and Participating Physicians provide to, or arrange for, Enrollees pursuant to a Health Benefit Plan and this Agreement.

Covered Services means the health and medical services described in Articles 2 and 11 of this Chapter as being eligible for reimbursement by AHCCCS.