COVERED SERVICES COVERED SERVICES NETWORK SERVICES OUT Sample Clauses

COVERED SERVICES COVERED SERVICES NETWORK SERVICES OUT. OF-NETWORK SERVICES A. AMBULANCE SERVICE 90% PRC 70% PRC B. DENTAL SERVICES RELATED TO ACCIDENTAL INJURY 90% PRC 70% PRC C. DIABETES TREATMENT Equipment and Supplies 90% PRC 70% PRC Diabetes Education Program 90% PRC 70% PRC D. DIAGNOSTIC SERVICES 90% PRC 70% PRC E. XX. XXXX ORNISH PROGRAM (For Reversing Heart Disease) 90% PRC 70% PRC Maximum of one (1) enrollment per lifetime F. DURABLE MEDICAL EQUIPMENT 90% XXX 00% XXX X. ENTERAL FORMULAE 90% PRC 70% PRC H. FAMILY PLANNING AND INFERTILITY SERVICES 90% PRC 70% PRC I. HOME HEALTH CARE SERVICES 90% PRC 70% PRC 100 Visit Maximum per Benefit Period J. HOME INFUSION THERAPY SERVICES 90% PRC 70% PRC K. HOSPICE CARE SERVICES 90% PRC 70% PRC L. HOSPITAL SERVICES 90% PRC 70% PRC Unlimited days per Benefit Period 90 days per Benefit Period COVERED SERVICES NETWORK SERVICES OUT-OF-NETWORK SERVICES Private Room Allowance 90% PRC 70% PRC for the most common semiprivate room charge Private Room covered when Medically Necessary and Appropriate. Emergency Accident Services 90% PRC Same as Network Services Emergency Medical Services 90% PRC Same as Network Services Pre-Admission Testing 90% PRC 70% PRC Surgery 90% PRC 70% PRC M. MATERNITY SERVICES 90% PRC 70% PRC Maternity Home Health Care Visit One (1) maternity home health care visit within forty-eight (48) hours of discharge when discharge occurs prior to (a) forty-eight (48) hours of Inpatient care following a normal vaginal delivery; or (b) ninety-six (96) hours of Inpatient care following a Caesarean delivery. Such visit is exempt from any Coinsurance amount.
Sample 1Sample 2Sample 3
AutoNDA by SimpleDocs
COVERED SERVICES COVERED SERVICES NETWORK SERVICES OUT. OF-NETWORK SERVICES A. AMBULANCE SERVICE 90% PRC 70% PRC B. DENTAL SERVICES RELATED TO ACCIDENTAL INJURY 90% PRC 70% PRC C. DIABETES TREATMENT Equipment and Supplies 90% PRC 70% PRC Diabetes Education Program 90% PRC 70% PRC D. DIAGNOSTIC SERVICES 90% PRC 70% PRC E. DURABLE MEDICAL EQUIPMENT 90% PRC 70% PRC BSMUHDHP1200-O COVERED SERVICES NETWORK SERVICES OUT-OF-NETWORK SERVICES F. ENTERAL FORMULAE 90% PRC 70% PRC Enteral Formulae benefits are exempt from all deductibles.
Sample 1

Related to COVERED SERVICES COVERED SERVICES NETWORK SERVICES OUT

  • Covered Services Services to be performed by Contractor under this Agreement may involve the performance of trade work covered by the provisions of Section 6.22(e) [Prevailing Wages] of the Administrative Code or Section 21C [Miscellaneous Prevailing Wage Requirements] (collectively, “Covered Services”). The provisions of Section 6.22(e) and 21C of the Administrative Code are incorporated as provisions of this Agreement as if fully set forth herein and will apply to any Covered Services performed by Contractor and its subcontractors.

  • Required Services Consultant agrees to perform the services, and deliver to City the “Deliverables” (if any) described in the attached Exhibit A, incorporated into the Agreement by this reference, within the time frames set forth therein, time being of the essence for this Agreement. The services and/or Deliverables described in Exhibit A shall be referred to herein as the “Required Services.”

  • Network Services Local Access Services In lieu of any other rates and discounts, Customer will pay fixed monthly recurring local loop charges ranging from $1,200 to $2,000 for TDM-based DS-3 Network Services Local Access Services at 2 CLLI codes mutually agreed upon by Customer and Company.

  • Shared Services 5.1.1 ETFO agrees to adopt a shared services model that will allow other Trusts to join the shared services model. The shared services office of the Trust is responsible for the services to support the administration of benefits for the members, and to assist in the delivery of benefits on a sustainable, efficient and cost effective basis.

  • Non-Covered Services MCOs are not permitted to provide Medicaid excluded services that include, but are not limited to, the following:

  • Hosting Services 13.1 If Supplier or its subcontractor, affiliate or any other person or entity providing products or services under the Contract Hosts Customer Data in connection with an Acquisition, the provisions of Appendix 1, attached hereto and incorporated herein, apply to such Acquisition.

  • Bundled Services If Cable Services subject to the Franchise Fee required under this Section 6 are provided to Subscribers in conjunction with Non-Cable Services, the Franchise Fee shall be applied only to the value of the Cable Services, as reflected on the books and records of Franchisee in accordance with FCC or state public utility regulatory commission rules, regulations, standards or orders.

  • Program Services a) Personalized Care Practice agrees to provide to Program Member certain enhancements and amenities to professional medical services to be rendered by Personalized Care Practice to Program Member, as further described in Schedule 1 to these Terms. Upon prior written notice to Program Member, Personalized Care Practice may add or modify the Program Services set forth in Schedule 1, as reasonably necessary, and subject to such additional fees and/or terms and conditions as may be reasonably necessary.

  • Managed Services HP will provide the services as described in a Statement of Work (“SOW”) attached to this Agreement or incorporating it by reference. Each party will appoint a single point of contact as set forth in the SOW who will serve as their primary representative, have overall responsibility for managing performance, and meet with the other party’s representative to review progress. Change requests are governed by the change management procedures as set forth in the SOW.

  • 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.

Time is Money Join Law Insider Premium to draft better contracts faster.