Covered Services Poststabilization Care Services Sample Clauses
The Covered Services—Poststabilization Care Services clause defines the obligations of a healthcare provider or insurer to cover and provide care to patients after their medical condition has been stabilized following an emergency. This typically includes services necessary to maintain the patient's stabilized condition or to address any unforeseen complications that arise after the initial emergency treatment. By specifying the scope of poststabilization care, the clause ensures that patients continue to receive necessary medical attention without interruption, thereby preventing gaps in coverage and promoting patient safety during the transition from emergency to ongoing care.
Covered Services Poststabilization Care Services. 4.4.1 Poststabilization Care Services, Generally The Contractor shall cover and pay for Poststabilization Care Services in accordance with the guidelines found in 42 CFR § 422.113(c). Generally, Poststabilization Care Services begin when an Enrollee is admitted for an inpatient hospital stay after the Enrollee has received Emergency Services.
4.4.2 Pre-Approved Poststabilization Care Services The Contractor is financially responsible for Poststabilization Care Services obtained by an Enrollee from a Network Provider or a Non-Network Provider that are pre- approved by a Contractor representative.
Covered Services Poststabilization Care Services