Common use of Anesthesiology Services Clause in Contracts

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 States Department of Defense (“DoD”) to arrange for the provision of health and administrative services to certain Members of the Civilian Health and Medical Program of the Uniformed Services (“CHAMPUS), and may contract with other local, Stale or federal agencies to arrange for the provision of health, administrative and certain other services to the Beneficiaries of other local, State and/or federal programs.

Anesthesiology Services. PPG or Participating Provider shall be compensated for Contracted Services at (a) *** $29.90 per unit value in the American Society of Anesthesiology Relative Value study or (b) *** seventy-five percent (75%) of the Participating Provider’s billed charges, whichever is less. Assistant Surgeons: PG 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) 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 APPLICABLE TO THIS AGREEMENT ADDENDUM G CHAMPUS/TRICARE AND OTHER GOVERNMENT BENEFIT PROGRAMS PPG understands and agrees that the obligations of FHS HNI set forth in this Addendum are the obligations of Foundation Health Federal Service Inc., an Affiliate of FHS HNI (“FHFS”), and not obligations of FHSHNI, or any other Affiliate of FHSHNI. FHFS may contract with the United States Department of Defense (“DoD”) to arrange for the provision of health and administrative services to certain Members of the Civilian Health and Medical Program of the Uniformed Services (“CHAMPUS), and may contract with other local, Stale State or federal agencies to arrange for the provision of health, administrative and certain other services to the Beneficiaries of other local, State and/or federal programs.

Anesthesiology Services. PPG or Participating Provider shall be compensated for Contracted Constructed 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 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) 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 nutritional) counseling OB standby other services which do not warrant extra charge: delivery of twins/multiple births, physician’s supervision of home careCare, hospitalization during pregnancy for conditions such as pre-clempsia, clethpsia. HTN Antepartum care only: First trimester only $ *** Second trimester inmester 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 86 ADDENDUM F.1 FEE-FOR-SERVICE COMPENSATION SCHEDULE ASSIGNED AND UNASSIGNED MEDI-CAL MEDICAL HMO MEMBERS (NOT APPLICABLE) 86 87 ADDENDUM F.2 CAPITATION COMPENSATION SCHEDULE (NOT APPLICABLE) 87 88 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 90 ADDENDUM F.5 DISCLOSURE FORM (NOT APPLICABLE) 90 91 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 States Department of Defense (“DoD”) to in arrange for the provision of health and administrative services to certain Members of the Civilian Health and Medical Program of the Uniformed Services (“CHAMPUS), and may contract with other local, Stale State or federal agencies to arrange for the provision of health, administrative and certain other services to the Beneficiaries of other local, State and/or federal programs.

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 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) 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 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 82 ADDENDUM F.1 FEE-FOR-SERVICE COMPENSATION SCHEDULE ASSIGNED AND UNASSIGNED MEDI-CAL HMO MEMBERS (NOT APPLICABLE) 86 83 ADDENDUM F.2 CAPITATION COMPENSATION SCHEDULE (NOT APPLICABLE) 87 84 ADDENDUM F.3 SHARED RISK PROGRAM DISTRIBUTION MATRIX (NOT APPLICABLE) 85 ADDENDUM F.4 DIVISION OF FINANCIAL RESPONSIBILITY MATRIX OF FHS AND PPG RISK SERVICES MEDI-CAL BENEFIT PROGRAM (NOT APPLICABLE) 89 86 ADDENDUM F.5 DISCLOSURE FORM (NOT APPLICABLE) 90 87 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 States Department of Defense (“DoD”) to arrange for the provision of health and administrative services to certain Members of the Civilian Health and Medical Program of the Uniformed Services (“CHAMPUS), and may contract with other local, Stale State or federal agencies to arrange for the provision of health, administrative and certain other services to the Beneficiaries of other local, State and/or federal programs.