Child Health Supervision Services Sample Clauses

Child Health Supervision Services a. Periodic Physician-delivered or Physician-supervised services from the moment of birth through the end of the month in which a Covered Dependent child turns 19, are covered as follows:
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Child Health Supervision Services. The following covered service is provided for an eligible child in accordance with the Florida Child Health Assurance Act which includes covered services from the moment of birth to age 16 years. A waiver of the deductible amount applies to all eligible service expenses for Child Health Supervision Services. Child Health Supervision Services means physician-delivered or physician-supervised services that include the services described in the Schedule of Benefits. These services do not include hospital charges. Child Health Supervision Services include periodic visits, which shall include:  History  Physical ExaminationDevelopmental AssessmentAnticipatory Guidance  Appropriate Immunizations  Laboratory Testing These services and periodic visits will be provided in accordance with prevailing medical standards consistent with the Recommendations for Preventive Pediatric Health Care of the American Academy of Pediatrics. Eligible service expenses for child health supervision services are limited to one visit payable to one provider for all the services provided at each visit. Newborns’ and Mothers’ Health Protection Act Statement of Rights If services provided or expenses incurred for hospital confinement in connection with childbirth are otherwise included as covered Service expenses, we will not limit the number of days for these expenses to less than that stated in this provision. Maternity care Coverage for outpatient and inpatient pre- and post-partum care including exams, prenatal diagnosis of genetic disorder, laboratory and radiology diagnostic testing, health education, nutritional counseling, risk assessment, childbirth classes, services of nurse-midwives and midwives licensed according to Florida law, and the services of birth centers licensed according to Florida law, if such services are available within the service area, and hospital stays for delivery or other medically necessary reasons (less any applicable copayments, deductible amounts, or cost sharing percentage). Other maternity benefits include complications of pregnancy, parent education, assistance, and training in breast or bottle feeding and the performance of any necessary and appropriate clinical tests. Coverage will only be provided for maternity services and/or care of the newborn child when such services have been authorized by your participating health care provider. Under federal law, health insurance issuers generally may not restrict benefits otherwise provided for a...
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Child Health Supervision Services. The periodic review of a child's physical and emotional status by a Physician or other Provider pursuant to a Physician's supervision, including a history, complete physical examination, developmental assessment, anticipatory guidance, appropriate immunizations and laboratory tests in keeping with prevailing medical standards. Child Health Supervision Services must be rendered during a periodic review, provided by or under the supervision of a single Physician during the course of one visit. The periodic review must be conducted within the following frequency schedule:
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Child Health Supervision Services. The following covered service is provided for an eligible child in accordance with the Florida Child Health Assurance Act which includes covered services from the moment of birth to age 16 years. A waiver of the deductible amount applies to all eligible service expenses for Child Health Supervision Services. Child Health Supervision Services means physician-delivered or physician-supervised services. These services do not include hospital charges. Child Health Supervision Services include periodic visits, which shall include:  History  Anticipatory GuidancePhysical ExaminationDevelopmental Assessment  Appropriate Immunizations  Laboratory Testing These services and periodic visits will be provided in accordance with prevailing medical standards consistent with the Recommendations for Preventive Pediatric Health Care of the American Academy of Pediatrics. Eligible service expenses for child health supervision services are limited to one visit payable to one provider for all the services provided at each visit. Newborns’ and Mothers’ Health Protection Act Statement of Rights Health Insurance Issuers generally may not, under federal law, restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child to less than 48 hours following a vaginal delivery, or less than 96 hours following a cesarean section. However, federal law generally does not prohibit the mother's or newborn's attending provider, after consulting with the mother, from discharging the mother or her newborn earlier than 48 hours (or 96 hours as applicable). In any case, plans and issuers may not, under federal law, require that a provider obtain authorization from the plan or the issuer for prescribing a length of stay not in excess of 48 hours (or 96 hours).
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Child Health Supervision Services. The following covered service is provided for an eligible child in accordance with the Florida Child Health Assurance Act which includes covered services from the moment of birth to age 16 years. A waiver of the deductible amount applies to all eligible service expenses for Child Health Supervision Services.
Sample 1
Child Health Supervision Services. The periodic review of a child's physical and emotional status by a Physician or other Provider pursuant to a Physician's supervision, including a history, complete physical examination, developmental assessment, anticipatory guidance, appropriate immunizations and laboratory tests in keeping with prevailing medical standards. Child Health Supervision Services must be rendered during a periodic review, provided by or under the supervision of a single Physician during the course of one visit. The periodic review must be conducted within the following frequency schedule: • Up to six reviews in the first year following the child's birth; • Up to two reviews for children between the ages of one and two; • One review each year for children ages three through six; and • One review every two years for children ages seven through 18. Child Health Supervision Services are limited to Insureds under age 19.
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Related to Child Health Supervision Services

  • Medical Services Plan 10.1.1 Regular Full-Time and Temporary Full-Time Employees shall be entitled to be covered under the Medical Services Plan commencing the first day of the calendar month following the date of employment.

  • Covered Health Care Services We agree to provide coverage for medically necessary covered health care services listed in this agreement. If a service or category of service is not specifically listed as covered, it is not covered under this agreement. Only services that we have reviewed and determined are eligible for coverage under this agreement are covered. All other services are not covered. See Section 1.4 for how we identify new services and our guidelines for reviewing and making coverage determinations. We only cover a service listed in this agreement if it is medically necessary. We review medical necessity in accordance with our medical policies and related guidelines. The term medically necessary is defined in Section 8.0 - Glossary. It does not include all medically appropriate services. The amount of coverage we provide for each health care service differs according to whether or not the service is received: • as an inpatient; • as an outpatient; • in your home; • in a doctor’s office; or • from a pharmacy. Also coverage differs depending on whether: • the health care provider is a network provider or non-network provider; • deductibles (if any), copayments, or maximum benefit apply; • you have reached your plan year maximum out-of-pocket expense; • there are any exclusions from coverage that apply; or • our allowance for a covered health care service is less than the amount of your copayment and deductible (if any). In this case, you will be responsible to pay up to our allowance when services are rendered by a network provider. Please see the Summary of Medical Benefits to determine the benefit limits and amount that you pay for the covered health care services listed below. Please see the Summary of Pharmacy Benefits to determine the benefit limits and amount that you pay for prescription drug and diabetic equipment and supplies purchased at a pharmacy.

  • Clinical Management for Behavioral Health Services (CMBHS) System The CMBHS is the official record of documentation by System Agency. Grantee shall:

  • Educational Services Any service or supply for education, training or retraining services or testing including: special education, remedial education; cognitive remediation; wilderness/outdoor treatment, therapy or adventure programs (whether or not the program is part of a Residential Treatment facility or otherwise licensed institution); job training or job hardening programs; educational services and schooling or any such related or similar program including therapeutic programs within a school setting.

  • Emergency Medical Services The City’s Fire Department and MedStar (or other entity engaged by the City after the Effective Date) will provide emergency medical services.

  • 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.

  • Paramedical Services Services of the following registered/certified practitioners up to the maximums shown on the "Summary of Benefits" pages:

  • 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.

  • Mastectomy Services Inpatient This plan provides coverage for a minimum of forty-eight (48) hours in a hospital following a mastectomy and a minimum of twenty-four (24) hours in a hospital following an axillary node dissection. Any decision to shorten these minimum coverages shall be made by the attending physician in consultation with and upon agreement with you. If you participate in an early discharge, defined as inpatient care following a mastectomy that is less than forty-eight (48) hours and inpatient care following an axillary node dissection that is less than twenty-four (24) hours, coverage shall include a minimum of one (1) home visit conducted by a physician or registered nurse.

  • PROFESSIONAL DEVELOPMENT AND EDUCATIONAL IMPROVEMENT A. The Board agrees to implement the following:

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