Clinical Preventive Health Services Sample Clauses

Clinical Preventive Health Services. This benefit has one or more exclusions as specified in the Exclusions Section. We will provide Coverage for Clinical Preventive Health Services without any Cost Sharing if you receive these services from our In-network Practitioners/Providers. If you receive these services from Out-of-network Practitioners/Providers you are responsible for the Out-of-network level Cost Sharing amounts. Refer to your Summary of Benefits and Coverage for Out-of-network Cost Sharing amounts. We will provide Coverage for preventive benefits, as defined by the Affordable Care Act (ACA), if you receive these services from our In-network Practitioners/Providers, without Cost Sharing regardless of sex assigned at birth, gender identity, or gender of the individual. Clinical Preventive Health Services Coverage is provided for services under four broad categories: • Screening and Counseling ServicesRoutine Immunizations • Childhood Preventive Services • Preventive Services for Women
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Clinical Preventive Health Services. Physical examinations, vaccinations, drugs and immunizations for the primary intent of medical research or non-Medically Necessary purpose(s) such as, but not limited to, licensing, certification, employment, insurance, flight, foreign travel, passports or functional capacity examinations related to employment are not Covered. Immunizations for the purpose of foreign travel are not Covered. Complementary Therapies Complementary Therapies, except those specified in the Complementary Therapies Benefits Section, are not Covered. · Acupuncture – Except as specified under Complementary Therapies in the Benefits Section.
Clinical Preventive Health Services. ‌ This benefit has one or more exclusions as specified in the Exclusions Section. We will provide Coverage for Clinical Preventive Health Services without any Cost Sharing at an age and frequency as determined by your In-network Practitioner/Provider. We will provide Coverage for preventive benefits, as defined by the Affordable Care Act (ACA), without Cost Sharing regardless of sex assigned at birth, gender identity, or gender of the individual. Clinical Preventive Health Services Coverage is provided for services under four broad categories: • Screening and Counseling ServicesRoutine Immunizations • Childhood Preventive Services • Preventive Services for Women

Related to Clinical Preventive Health Services

  • 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.

  • Behavioral Health Services Behavioral health services include the evaluation, management, and treatment for a mental health or substance use disorder condition. For the purpose of this plan, substance use disorder does not include addiction to or abuse of tobacco and/or caffeine. Mental health or substance use disorders are those that are listed in the most updated volume of either: • the Diagnostic and Statistical Manual of Mental Disorders (DSM) published by the American Psychiatric Association; or • the International Classification of Disease Manual (ICD) published by the World Health Organization. This plan provides parity in benefits for behavioral healthcare services. Please see Section 10 for additional information regarding behavioral healthcare parity. Inpatient This plan covers behavioral health services if you are inpatient at a general or specialty hospital. See Inpatient Services in Section 3 for additional information. Residential Treatment Facility This plan covers services at behavioral health residential treatment facilities, which provide: • clinical treatment; • medication evaluation management; and • 24-hour on site availability of health professional staff, as required by licensing regulations. Intermediate Care Services This plan covers intermediate care services, which are facility-based programs that are: • more intensive than traditional outpatient services; • less intensive than 24-hour inpatient hospital or residential treatment facility services; and • used as a step down from a higher level of care; or • used a step-up from standard care level of care. Intermediate care services include the following: • Partial Hospital Program (PHP) – PHPs are structured and medically supervised day, evening, or nighttime treatment programs providing individualized treatment plans. A PHP typically runs for five hours a day, five days per week. • Intensive Outpatient Program (IOP) – An IOP provides substantial clinical support for patients who are either in transition from a higher level of care or at risk for admission to a higher level of care. An IOP typically runs for three hours per day, three days per week.

  • Mental Health Services This agreement covers medically necessary services for the treatment of mental health disorders in a general or specialty hospital or outpatient facilities that are: • reviewed and approved by us; and • licensed under the laws of the State of Rhode Island or by the state in which the facility is located as a general or specialty hospital or outpatient facility. We review network and non-network programs, hospitals and inpatient facilities, and the specific services provided to decide whether a preauthorization, hospital or inpatient facility, or specific services rendered meets our program requirements, content and criteria. If our program content and criteria are not met, the services are not covered under this agreement. Our program content and criteria are defined below.

  • COUNTY’S QUALITY ASSURANCE PLAN The County or its agent will evaluate the Contractor’s performance under this Contract on not less than an annual basis. Such evaluation will include assessing the Contractor’s compliance with all Contract terms and conditions and performance standards. Contractor deficiencies which the County determines are severe or continuing and that may place performance of the Contract in jeopardy if not corrected will be reported to the Board of Supervisors. The report will include improvement/corrective action measures taken by the County and the Contractor. If improvement does not occur consistent with the corrective action measures, the County may terminate this Contract or impose other penalties as specified in this Contract.

  • Accident Prevention Health and Safety Committee The Employer and the Union agree that they mutually desire to maintain standards of safety and health in the Hospital in order to prevent accidents, in jury and illness. its responsibilities under the applicable legislation, the agrees to accept as a member of its Accident Prevention Health 6 Safety Committee at l e a s t one representative selected or appointed by the Union from amongst bargaining unit employees. shall identify potential dangers and hazards, institute means of improving health and programs and recommend to be a e improve related and health. The Hospital agrees to co-operate i providing information to enable the Committee to its function. shall i be at the call of Chair if shall minutes O f all meetings t h e s a m e available for representative o r selected accordance with shall serve for a of one calendar year the date of appointment which may renewed for further periods of one year. off for such to attend meetings of the Accident Prevention and Safety Committee accordance with shall and spent s h a l l be deemed to b e work time for which the representative(s) shall be paid by the a t his/her regular or premium rate as m a y be applicable. ARTICLE PAID The Holidays with pay for this Agreement shall be: New's Years Day Good Friday Easter Monday Victoria Day Dominion Da) Holiday (as locally declared) During of this the Day, which is not a day, shall be granted third in If a that shall replace this holiday. t the nature of services necessary a Hospital, of the e m p l o y e e s ma be required work these In general, may required alternate with other in absent instance, an e m p l o y e e having Day off 0 be off on Year's Day. a the preference. To qualify for holiday pay as above, an employee must work his or her full regularly scheduled shift immediately preceding and his or her full regularly scheduled shift immediately succeeding the Holiday. In the event of an employee being prevented from working the shift immediately preceding and/or succeeding such holiday by reason of illness, authenticated by medical certificate or otherwise, lasting more than five full working such employee shall qualify for holiday pay, it being further understood and agreed that no employee shall receive holiday pay for more than one holiday during any one illness except for holidays over the Christmas and Year's periods, in which case no employee shall receive pay for more than three holidays. of the above named holidays an regular day off, or during his or her vacation the employee receive off payment for holidays in lieu thereof, but additional shall not be added to the period of vacation of employee except the of the Department his work shall time half time rate of o r . such in addition any entitled or at the option of the the employee may be paid time one half for the time worked and a paid day off in lieu thereof, or, (or a further option of the Hospital), the employee may be paid his regular straight time plus a paid clay and a half off in lieu thereof. Failure report for work assigned on such holiday shall disqualify employee for holiday pay.

  • Health Services At the time of employment and subject to (b) above, full credit for registered professional nursing experience in a school program shall be given. Full credit for registered professional nursing experience may be given, subject to approval by the Human Resources Division. Non-degree nurses shall be placed on the BA Track of the Teachers Salary Schedule and shall be ineligible for movement to any other track.

  • Synchronization, Commissioning and Commercial Operation 4.1.1 The Power Producer shall give at least thirty (30) days written notice to the SLDC and GUVNL, of the date on which it intends to synchronize the Power Project to the Grid System.

  • Quality Assurance/Quality Control Contractor shall establish and maintain a quality assurance/quality control program which shall include procedures for continuous control of all construction and comprehensive inspection and testing of all items of Work, including any Work performed by Subcontractors, so as to ensure complete conformance to the Contract with respect to materials, workmanship, construction, finish, functional performance, and identification. The program established by Contractor shall comply with any quality assurance/quality control requirements incorporated in the Contract.

  • Disease Management If you have a chronic condition such as asthma, coronary heart disease, diabetes, congestive heart failure, and/or chronic obstructive pulmonary disease, we’re here to help. Our tools and information can help you manage your condition and improve your health. You may also be eligible to receive help through our care coordination program. This voluntary program is available at no additional cost you. To learn more about disease management, please call (000) 000-0000 or 0-000-000-0000. About This Agreement Our entire contract with you consists of this agreement and our contract with your employer. Your ID card will identify you as a member when you receive the healthcare services covered under this agreement. By presenting your ID card to receive covered healthcare services, you are agreeing to abide by the rules and obligations of this agreement. Your eligibility for benefits is determined under the provisions of this agreement. Your right to appeal and take action is described in Appeals in Section 5. This agreement describes the benefits, exclusions, conditions and limitations provided under your plan. It shall be construed under and shall be governed by the applicable laws and regulations of the State of Rhode Island and federal law as amended from time to time. It replaces any agreement previously issued to you. If this agreement changes, an amendment or new agreement will be provided.

  • Health and Safety Plan 5. Xxxxxx shall prepare and submit under separate cover from the Work Plan, a Health and Safety Plan consistent with Occupational Safety and Health Administration regulations. The Health and Safety Plan shall be submitted to the Department in the form of one electronic copy on compact disk (in .pdf format). Xxxxxx agrees that the Health and Safety Plan is submitted to the Department only for informational purposes. The Department expressly disclaims any liability that may result from implementation of the Health and Safety Plan by Xxxxxx. PUBLIC PARTICIPATION

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