Anesthesiology Services Sample Clauses

Anesthesiology Services. PPG or Participating Provider shall be compensated for Contracted Services at (a) *** per unit value in the American Society of Anesthesiology Relative Value study or (b) *** of the Participating Provider’s billed charges, whichever is less. Assistant Surgeons: PG or Participating Provider shall be compensated for Contracted Services at *** of the surgeon’s reimbursement as determined above. Total Obstetrical Care: (for HMO Benefit Programs) Total OB care, vaginal delivery $*** global rate Total OB care, Cesarean delivery $*** global rate Services included in global reimbursement (professional and technical component) for total OB care: Total OB care, vaginal delivery *** global rate Total OB care, Cesarean delivery $*** global rate Services included in global reimbursement for total OB care: office visits (sick care as well as routine) consultations including initial OB consultation emergency department visits therapeutic injections amniocentesis fetal contraction stress test fetal non-stress test fetal monitoring, including initiation or supervision version delivery of placenta ultrasound laboratory tests venipuncture specimen collection and laboratory supplies educational materials/nutritional counseling OB standby other services which do not warrant extra charge: delivery of twins/multiple births, physician’s supervision of home care, hospitalization during pregnancy for conditions such as pre-clempsia, HTN Antepartum care only: First trimester only $ *** Second trimester only $ *** First and second trimester only $ *** Third trimester excluding delivery $ *** Third trimester including delivery $ *** CONFIDENTIAL, PROPRIETARY AND TRADE SECRET ADDENDUM F MEDI-CAL BENEFIT PROGRAM (NOT APPLICABLE) 85 ADDENDUM F.1 FEE-FOR-SERVICE COMPENSATION SCHEDULE ASSIGNED AND UNASSIGNED MEDI-CAL HMO MEMBERS (NOT APPLICABLE) 86 ADDENDUM F.2 CAPITATION COMPENSATION SCHEDULE (NOT APPLICABLE) 87 ADDENDUM F.3 SHARED RISK PROGRAM DISTRIBUTION MATRIX (NOT APPLICABLE) ADDENDUM F.4 DIVISION OF FINANCIAL RESPONSIBILITY MATRIX OF FHS AND PPG RISK SERVICES MEDI-CAL BENEFIT PROGRAM (NOT APPLICABLE) 89 ADDENDUM F.5 DISCLOSURE FORM (NOT APPLICABLE) 90 ADDENDUM G CHAMPUS/TRICARE AND OTHER GOVERNMENT BENEFIT PROGRAMS PPG understands and agrees that the obligations of FHS set forth in this Addendum are the obligations of Foundation Health Federal Service Inc., an Affiliate of FHS (“FHFS”), and not obligations of FHS, or any other Affiliate of FHS. FHFS may contract with the United Stat...
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Anesthesiology Services l. Mammography screening, as defined by state and federal law.
Sample 1
Anesthesiology Services. PPG or Participating Provider shall be compensated for Contracted Services at (a)*** unit value in the American Society of Anesthesiology Relative Value study or (b)*** of the Participating Provider’s billed charges, whichever is less Assistant Surgeons: PPG or Participating Provider shall be compensated for Contracted Services at twenty percent (20%) of the surgeon’s reimbursement as determined above. Total Obstetrical Care: (for HMO Benefit Programs) Services included in global reimbursement (professional and technical component): Total OB care, vaginal delivery $*** global rate Total OB care, Cesarean delivery $ *** global rate Services included in global reimbursement for total OB care: office visits (sick care as well as routine) consultations including initial OB consultation emergency department visits therapeutic injections amnimocentesis fetal contraction stress test fetal non-stress test fetal monitoring, including initiation or supervision version delivery of placenta ultrasound laboratory tests venipuncture specimen collection and laboratory supplies educational materials/nutritional counseling OB standby oilier services which do not warrant extra charge: delivery of twins/multiple births, physician’s supervision of home care, hospitalization during pregnancy for conditions such as pre-clempsia, HTN Antepartum care only: First trimester only $*** Second trimester only $*** First and second trimester only $*** Third trimester excluding delivery $*** Third trimester including delivery $***
Sample 1

Related to Anesthesiology Services

  • Anesthesia Services This plan covers general and local anesthesia services received from an anesthesiologist when the surgical procedure is a covered healthcare service. This plan covers office visits or office consultations with an anesthesiologist when provided prior to a scheduled covered surgical procedure.

  • Surgery Services This plan covers surgery services to treat a disease or injury when: • the operation is not experimental or investigational, or cosmetic in nature; • the operation is being performed at the appropriate place of service; and • the physician is licensed to perform the surgery. Preauthorization may be required for certain surgical services. Reconstructive Surgery for a Functional Deformity or Impairment This plan covers reconstructive surgery and procedures when the services are performed to relieve pain, or to correct or improve bodily function that is impaired as a result of: • a birth defect; • an accidental injury; • a disease; or • a previous covered surgical procedure. Functional indications for surgical correction do not include psychological, psychiatric or emotional reasons. This plan covers the procedures listed below to treat functional impairments. • abdominal wall surgery including panniculectomy (other than an abdominoplasty); • blepharoplasty and ptosis repair; • gastric bypass or gastric banding; • nasal reconstruction and septorhinoplasty; • orthognathic surgery including mandibular and maxillary osteotomy; • reduction mammoplasty; • removal of breast implants; • removal or treatment of proliferative vascular lesions and hemangiomas; • treatment of varicose veins; or • gynecomastia. Preauthorization may be required for these services.

  • Pharmacy Services The Contractor shall establish a network of pharmacies. The Contractor or its PBM must provide at least two (2) pharmacy providers within thirty (30) miles or thirty (30) minutes from a member’s residence in each county, as well as at least two (2) durable medical equipment providers in each county or contiguous county.

  • Laboratory Services Covered Services include prescribed diagnostic clinical and anatomic pathological laboratory services and materials when authorized by a Member's PCP and HPN’s Managed Care Program.

  • Radiation Therapy/Chemotherapy Services This plan covers chemotherapy and radiation services. Respiratory Therapy This plan covers respiratory therapy services. When respiratory services are provided in your home, as part of a home care program, durable medical equipment, supplies, and oxygen are covered as a durable medical equipment service.

  • Hospice Services Services are available for a Member whose Attending Physician has determined the Member's illness will result in a remaining life span of six months or less.

  • Transplant Services Expenses for the following are excluded:

  • Telemedicine Services This plan covers clinically appropriate telemedicine services when the service is provided via remote access through an on-line service or other interactive audio and video telecommunications system in accordance with R.I. General Law § 27-81-1. Clinically appropriate telemedicine services may be obtained from a network provider, and from our designated telemedicine service provider. When you seek telemedicine services from our designated telemedicine service provider, the amount you pay is listed in the Summary of Medical Benefits. When you receive a covered healthcare service from a network provider via remote access, the amount you pay depends on the covered healthcare service you receive, as indicated in the Summary of Medical Benefits. For information about telemedicine services, our designated telemedicine service provider, and how to access telemedicine services, please visit our website or contact our Customer Service Department.

  • Diagnostic Services Procedures ordered by a recognized Provider because of specific symptoms to diagnose a specific condition or disease. Some examples include, but are not limited to:

  • Infertility Services This plan covers the following services, in accordance with R.I. General Law §27-20-20. • Services for the diagnosis and treatment of infertility if you are:

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