{"component": "clause", "props": {"groups": [{"snippet": "The Plan provides Benefits for Medically Necessary hemodialysis and dialysis on an Inpatient or Outpatient basis, or at home. When the Member is eligible for coverage of hemodialysis and dialysis under Medicare, the Plan provides Benefits only to the extent payments would exceed what would be payable by Medicare. Your PCP or kidney specialist should make all arrangements for hemodialysis and dialysis care. Coverage for hemodialysis and dialysis in the home includes nondurable medical supplies, drugs, and equipment. To be covered, hemodialysis and dialysis services under this section must be ordered by a Physician.", "samples": [{"hash": "khfwxxCqtYz", "uri": "/contracts/khfwxxCqtYz#dialysis", "label": "Member Benefit Agreement", "score": 34.5023572045, "published": true}, {"hash": "e4cyPWNjcSl", "uri": "/contracts/e4cyPWNjcSl#dialysis", "label": "Member Benefit Agreement", "score": 34.5023572045, "published": true}, {"hash": "6GskUpvamAo", "uri": "/contracts/6GskUpvamAo#dialysis", "label": "Member Benefit Agreement", "score": 31.6744922038, "published": true}], "snippet_links": [{"key": "the-plan", "type": "clause", "offset": [0, 8]}, {"key": "benefits-for-medically-necessary", "type": "clause", "offset": [18, 50]}, {"key": "at-home", "type": "clause", "offset": [117, 124]}, {"key": "the-member", "type": "clause", "offset": [131, 141]}, {"key": "coverage-of", "type": "clause", "offset": [158, 169]}, {"key": "benefits-only", "type": "clause", "offset": [230, 243]}, {"key": "to-the-extent", "type": "clause", "offset": [244, 257]}, {"key": "dialysis-care", "type": "definition", "offset": [395, 408]}, {"key": "coverage-for", "type": "clause", "offset": [410, 422]}, {"key": "in-the-home", "type": "definition", "offset": [449, 460]}, {"key": "medical-supplies", "type": "clause", "offset": [481, 497]}, {"key": "and-equipment", "type": "clause", "offset": [506, 519]}, {"key": "dialysis-services", "type": "definition", "offset": [553, 570]}, {"key": "ordered-by", "type": "definition", "offset": [598, 608]}], "size": 14, "hash": "0427828281a8995a9b1c078477d0c081", "id": 1}, {"snippet": "Dialysis\" means a process by which dissolved substances are removed from a patient's body by diffusion from one fluid compartment to another across a semipermeable membrane. The 2 types of dialysis that are in common use are hemodialysis and peritoneal dialysis. [PL 1997, c. 658, \u00a71 (NEW).]", "samples": [{"hash": "67X9gpxjV08", "uri": "/contracts/67X9gpxjV08#dialysis", "label": "Definitions", "score": 29.0519196243, "published": true}, {"hash": "kcwMcXt8yOS", "uri": "/contracts/kcwMcXt8yOS#dialysis", "label": "Licensing of End Stage Renal Disease Facilities", "score": 28.9932099754, "published": true}, {"hash": "gmhWEpQtx1J", "uri": "/contracts/gmhWEpQtx1J#dialysis", "label": "Definitions", "score": 25.1067761807, "published": true}], "snippet_links": [{"key": "types-of", "type": "clause", "offset": [180, 188]}, {"key": "common-use", "type": "definition", "offset": [210, 220]}, {"key": "peritoneal-dialysis", "type": "definition", "offset": [242, 261]}], "size": 11, "hash": "54a5733bd90826b83aff7427f6a2f12f", "id": 2}, {"snippet": "Benefits will be provided for Medically Necessary dialysis services and supplies when Referred by the PCP. In the case of home dialysis, services include equipment, training, and medical supplies. The decision to purchase or rent necessary equipment for home dialysis will be made by Keystone.", "samples": [{"hash": "1yHf4fONIv9", "uri": "/contracts/1yHf4fONIv9#dialysis", "label": "Individual Hmo Subscriber Agreement", "score": 23.8843258042, "published": true}, {"hash": "k8cBChs7uVY", "uri": "/contracts/k8cBChs7uVY#dialysis", "label": "Individual Hmo Subscriber Agreement", "score": 23.8829568789, "published": true}, {"hash": "cfporzFXbOZ", "uri": "/contracts/cfporzFXbOZ#dialysis", "label": "Hmo Subscriber Agreement", "score": 23.8829568789, "published": true}], "snippet_links": [{"key": "benefits-will", "type": "clause", "offset": [0, 13]}, {"key": "medically-necessary", "type": "definition", "offset": [30, 49]}, {"key": "services-and-supplies", "type": "definition", "offset": [59, 80]}, {"key": "in-the-case", "type": "clause", "offset": [107, 118]}, {"key": "home-dialysis", "type": "definition", "offset": [122, 135]}, {"key": "services-include", "type": "clause", "offset": [137, 153]}, {"key": "medical-supplies", "type": "clause", "offset": [179, 195]}, {"key": "decision-to-purchase", "type": "clause", "offset": [201, 221]}, {"key": "necessary-equipment", "type": "definition", "offset": [230, 249]}], "size": 10, "hash": "1c64c566ef87bf37d1496c74cdf0fb86", "id": 3}, {"snippet": "No individual full-time or part-time employee shall be subject to a temporary reduction with respect to their normal work hours in excess of: Full-time (7.5 hour shifts) 5 days (37.5 hours) per calendar year Full-time (12 hour shifts) 3 days (34.5 hours) per calendar year Full-time (10 hour shifts) 4 days (38 hours) per calendar year Part-time (12 hour shifts) 2 days (23 hours) per calendar year Part-time (10 hour shifts) 3 days (28.5 hours) per calendar year Part-time (10 hour shifts) 2 days (19 hours) per calendar year Part-time 4 4 days (30 hours) per calendar year Part-time 3 3 days (22.5 hours) per calendar year Part-time 2 2 days (15 hours) per calendar year", "samples": [{"hash": "4G5f50vo86H", "uri": "/contracts/4G5f50vo86H#dialysis", "label": "Collective Bargaining Agreement", "score": 22.697467488, "published": true}, {"hash": "lI7Da370tg4", "uri": "/contracts/lI7Da370tg4#dialysis", "label": "Collective Bargaining Agreement", "score": 22.6098562628, "published": true}, {"hash": "bgBWIlSuiD3", "uri": "/contracts/bgBWIlSuiD3#dialysis", "label": "Collective Bargaining Agreement", "score": 22.3100616016, "published": true}], "snippet_links": [{"key": "time-employee", "type": "clause", "offset": [32, 45]}, {"key": "subject-to", "type": "definition", "offset": [55, 65]}, {"key": "temporary-reduction", "type": "clause", "offset": [68, 87]}, {"key": "with-respect-to", "type": "clause", "offset": [88, 103]}, {"key": "normal-work-hours", "type": "definition", "offset": [110, 127]}, {"key": "hour-shifts", "type": "definition", "offset": [157, 168]}, {"key": "calendar-year", "type": "clause", "offset": [194, 207]}], "size": 3, "hash": "fa94ff7526ec577f4e79e8401f3b77eb", "id": 4}, {"snippet": "No Home Health Care Benefits will be provided for:", "samples": [{"hash": "2w0VkC4FY98", "uri": "/contracts/2w0VkC4FY98#dialysis", "label": "Health Insurance Contract", "score": 20.7138945927, "published": true}, {"hash": "a1qIyyS7qJE", "uri": "/contracts/a1qIyyS7qJE#dialysis", "label": "Health Insurance Contract", "score": 19.2299794661, "published": true}, {"hash": "4upMFE2jJZo", "uri": "/contracts/4upMFE2jJZo#dialysis", "label": "Health Insurance Contract", "score": 19.2299794661, "published": true}], "snippet_links": [{"key": "benefits-will", "type": "clause", "offset": [20, 33]}], "size": 3, "hash": "632c2073797e197ffa6b40dfe98d8943", "id": 5}, {"snippet": "The treatment of acute renal failure or chronic irreversible renal insufficiency for removal of waste materials from the body by hemodialysis, peritoneal dialysis, hemoperfusion, or chronic ambulatory peritoneal dialysis (CAPD), or continuous cyclical peritoneal dialysis (CCPD).", "samples": [{"hash": "ewEl5dNGLdV", "uri": "/contracts/ewEl5dNGLdV#dialysis", "label": "Comprehensive Major Medical Group Booklet Certificate", "score": 21.0, "published": true}, {"hash": "cvCySEnjUhy", "uri": "/contracts/cvCySEnjUhy#dialysis", "label": "Health Benefits Plan", "score": 21.0, "published": true}], "snippet_links": [{"key": "treatment-of", "type": "clause", "offset": [4, 16]}, {"key": "renal-failure", "type": "definition", "offset": [23, 36]}, {"key": "renal-insufficiency", "type": "clause", "offset": [61, 80]}, {"key": "removal-of-waste-materials", "type": "clause", "offset": [85, 111]}, {"key": "peritoneal-dialysis", "type": "definition", "offset": [143, 162]}], "size": 2, "hash": "b4c59c0dffe4e5ad5391525e31762fb2", "id": 6}, {"snippet": "Ownership, operation and management of -------- facilities and businesses which provide hemodialysis services and treatments to patients with chronic or acute kidney diseases or conditions;", "samples": [{"hash": "8WYxGQLCIgU", "uri": "/contracts/8WYxGQLCIgU#dialysis", "label": "Employment Contract (Community Psychiatric Centers /Nv/)", "score": 18.0, "published": true}, {"hash": "7PnMnijuQYI", "uri": "/contracts/7PnMnijuQYI#dialysis", "label": "Employment Agreement (Community Psychiatric Centers /Nv/)", "score": 18.0, "published": true}], "snippet_links": [{"key": "management-of", "type": "clause", "offset": [25, 38]}, {"key": "services-and", "type": "clause", "offset": [101, 113]}], "size": 2, "hash": "f4ff03b421e41027747722a1418323dc", "id": 7}, {"snippet": "We will indemnify the Medical Expenses incurred in respect of the Insured Person\u2019s Treatment for Dialysis on written advice of a Medical Practitioner whilst on a Trip during the Period of Insurance provided that: o The Injury / illness diagnosed is not due to a Pre-existing condition unless specifically opted. o The treating Medical Practitioner certifies in writing the requirement of Dialysis with its frequency This includes pre and post-operative renal dialysis as part of intensive care and for ongoing maintenance while waiting for a kidney transplant for a limit of up to two years. If You have opted for the above Benefit, then the claim under the said cover will not be payable under Emergency Medical Expenses Accident & Illness/ Emergency Medical Expenses Accident /Out- patient Care/ Out-patient Care for Injury. This cover is also available as a fixed benefit option upto the sum insured specified in the Policy Schedule/ Certificate of Insurance or under the special conditions of the Policy Schedule/ Certificate of Insurance & subject to admissible claim as per the policy conditions applicable to this section including specific exclusion and to any other condition applicable to this policy. In respect to process claims, documents specified under Documentation section is necessary to evaluate the claim. All terms & conditions applicable to this cover remains same as mentioned in coverage, specific exclusion, General exclusion applicable to this section.", "samples": [{"hash": "1KxGAEOU7oc", "uri": "/contracts/1KxGAEOU7oc#dialysis", "label": "Smart Travel Policy", "score": 35.5495716008, "published": true}, {"hash": "3py1sf28MNu", "uri": "/contracts/3py1sf28MNu#dialysis", "label": "Insurance Policy", "score": 34.8540963752, "published": true}], "snippet_links": [{"key": "the-medical", "type": "definition", "offset": [18, 29]}, {"key": "expenses-incurred", "type": "clause", "offset": [30, 47]}, {"key": "in-respect-of", "type": "clause", "offset": [48, 61]}, {"key": "the-insured-person", "type": "clause", "offset": [62, 80]}, {"key": "written-advice", "type": "clause", "offset": [109, 123]}, {"key": "medical-practitioner", "type": "clause", "offset": [129, 149]}, {"key": "period-of-insurance", "type": "definition", "offset": [178, 197]}, {"key": "provided-that", "type": "clause", "offset": [198, 211]}, {"key": "existing-condition", "type": "clause", "offset": [266, 284]}, {"key": "in-writing", "type": "clause", "offset": [358, 368]}, {"key": "the-requirement", "type": "clause", "offset": [369, 384]}, {"key": "renal-dialysis", "type": "clause", "offset": [453, 467]}, {"key": "intensive-care", "type": "clause", "offset": [479, 493]}, {"key": "ongoing-maintenance", "type": "clause", "offset": [502, 521]}, {"key": "two-years", "type": "clause", "offset": [581, 590]}, {"key": "the-claim", "type": "definition", "offset": [638, 647]}, {"key": "emergency-medical-expenses", "type": "definition", "offset": [695, 721]}, {"key": "patient-care", "type": "clause", "offset": [784, 796]}, {"key": "benefit-option", "type": "clause", "offset": [867, 881]}, {"key": "sum-insured", "type": "definition", "offset": [891, 902]}, {"key": "certificate-of-insurance", "type": "definition", "offset": [937, 961]}, {"key": "of-the-policy", "type": "clause", "offset": [994, 1007]}, {"key": "subject-to", "type": "definition", "offset": [1045, 1055]}, {"key": "applicable-to", "type": "clause", "offset": [1102, 1115]}, {"key": "specific-exclusion", "type": "clause", "offset": [1139, 1157]}, {"key": "other-condition", "type": "clause", "offset": [1169, 1184]}, {"key": "this-policy", "type": "definition", "offset": [1199, 1210]}, {"key": "in-respect-to", "type": "clause", "offset": [1212, 1225]}, {"key": "process-claims", "type": "definition", "offset": [1226, 1240]}, {"key": "terms-conditions", "type": "definition", "offset": [1330, 1348]}, {"key": "general-exclusion", "type": "clause", "offset": [1433, 1450]}], "size": 2, "hash": "8b74837787a09fa6b8790fbda513b586", "id": 8}, {"snippet": "Independently provide and monitor haemodialysis treatment including providing pre-and post- haemodialysis care. \u2022 Appropriately respond to clinical changes or deterioration in the consumer's condition and initiate consultations with relevant caregivers as required. \u2022 Provide comprehensive educating to consumers following their treatments including home care needs, diet, nutrition, exercise programs and any self-administration medication. \u2022 Demonstrate knowledge and best practice principals for continence management, diabetes management, palliative care, wound management. \u2022 Manage clinical risks such as hydration, nutrition, pain, pressure, wound, and delirium. \u2022 Facilitate and encourage social connections between consumers and their health care team, and families. \u2022 Collaborates with the services multidisciplinary team to achieve the best health outcomes for our consumers. \u2022 Care plans are comprehensive and at minimum meet legislative and standards requirements. \u2022 Consumers are encouraged and supported to participate in lifestyle activities. \u2022 The most senior clinician on site and represents YDHS and the YDHS Senior Management Team members professionally to consumers, caregivers, and our community. \u2022 Facilitate safe and seamless care to consumers across the health service. \u2022 Manage demand, capacity, and patient flow. \u2022 Facilitate and support appropriate consumer transfers. \u2022 Act as the emergency response coordinator. \u2022 Manage organisational risks by collaborating with relevant teams to ensure interdisciplinary problem solving. \u2022 Management of the unit staff roster. \u2022 Utilising available data to develop a roster of adequately skilled staff. \u2022 Ensure caregiver/patient ratios meet the needs of the unit. \u2022 Ensure Caregivers understand their roles and responsibilities within their scope of practice. \u2022 Promote appropriate behaviour and create an environment of accountability. \u2022 Facilitate education as required to ensure consumer safety. \u2022 Understand and abide by the National Safety and Quality Health Service (NSQHS) Standards. \u2022 Understand and abide by the Aged Care Quality Standards. \u2022 Practice self-reflection and awareness, identify skills and knowledge gaps and seek assistance and supervision when required. \u2022 Adopt a quality mentality and actively look for ways we can improve our service and clinical care offers. \u2022 Create a continuous improvement environment by supporting each other to learn, providing guidance, clinical supervision, and mentoring and precepting. \u2022 Understand the responsibility for minimising the risk of acquisition or exposure of infections to patients, residents, visitors and health care workers, arising from activities within the health care environment.", "samples": [{"hash": "j3jsTiTQK3k", "uri": "/contracts/j3jsTiTQK3k#dialysis", "label": "Position Description", "score": 25.1136208077, "published": true}], "snippet_links": [{"key": "respond-to", "type": "definition", "offset": [128, 138]}, {"key": "the-consumer", "type": "definition", "offset": [176, 188]}, {"key": "as-required", "type": "clause", "offset": [253, 264]}, {"key": "care-needs", "type": "definition", "offset": [355, 365]}, {"key": "best-practice", "type": "clause", "offset": [470, 483]}, {"key": "palliative-care", "type": "clause", "offset": [543, 558]}, {"key": "social-connections", "type": "clause", "offset": [696, 714]}, {"key": "health-care-team", "type": "definition", "offset": [743, 759]}, {"key": "the-services", "type": "definition", "offset": [795, 807]}, {"key": "multidisciplinary-team", "type": "clause", "offset": [808, 830]}, {"key": "health-outcomes", "type": "definition", "offset": [851, 866]}, {"key": "care-plans", "type": "clause", "offset": [888, 898]}, {"key": "and-standards", "type": "clause", "offset": [949, 962]}, {"key": "participate-in", "type": "definition", "offset": [1021, 1035]}, {"key": "most-senior", "type": "definition", "offset": [1064, 1075]}, {"key": "management-team-members", "type": "clause", "offset": [1134, 1157]}, {"key": "health-service", "type": "clause", "offset": [1278, 1292]}, {"key": "and-support", "type": "clause", "offset": [1352, 1363]}, {"key": "response-coordinator", "type": "definition", "offset": [1419, 1439]}, {"key": "to-ensure", "type": "clause", "offset": [1508, 1517]}, {"key": "problem-solving", "type": "definition", "offset": [1536, 1551]}, {"key": "unit-staff", "type": "definition", "offset": [1573, 1583]}, {"key": "available-data", "type": "clause", "offset": [1604, 1618]}, {"key": "to-develop", "type": "definition", "offset": [1619, 1629]}, {"key": "roles-and-responsibilities", "type": "definition", "offset": [1767, 1793]}, {"key": "scope-of-practice", "type": "definition", "offset": [1807, 1824]}, {"key": "appropriate-behaviour", "type": "clause", "offset": [1836, 1857]}, {"key": "the-national", "type": "clause", "offset": [1991, 2003]}, {"key": "safety-and-quality", "type": "clause", "offset": [2004, 2022]}, {"key": "aged-care-quality-standards", "type": "definition", "offset": [2087, 2114]}, {"key": "skills-and-knowledge", "type": "clause", "offset": [2167, 2187]}, {"key": "when-required", "type": "definition", "offset": [2229, 2242]}, {"key": "our-service", "type": "clause", "offset": [2314, 2325]}, {"key": "clinical-care", "type": "definition", "offset": [2330, 2343]}, {"key": "improvement-environment", "type": "clause", "offset": [2374, 2397]}, {"key": "clinical-supervision", "type": "clause", "offset": [2453, 2473]}, {"key": "responsibility-for", "type": "clause", "offset": [2522, 2540]}, {"key": "the-risk", "type": "definition", "offset": [2552, 2560]}, {"key": "and-health", "type": "clause", "offset": [2635, 2645]}], "size": 1, "hash": "1e7d8d0d30981e69c58017cb685648d5", "id": 9}, {"snippet": "Expenses concerning dialysis \u2013 including all doctor, room-meal-companion, medication, diagnosis unit expenses \u2013 regardless of whether they are inpatient or outpatient, will be paid within the limit specified in the policy and the special and general conditions.", "samples": [{"hash": "9z65obAhWDm", "uri": "/contracts/9z65obAhWDm#dialysis", "label": "Group Health Insurance Contract", "score": 28.3908924664, "published": true}], "snippet_links": [{"key": "the-policy", "type": "clause", "offset": [211, 221]}, {"key": "special-and-general-conditions", "type": "clause", "offset": [230, 260]}], "size": 1, "hash": "bf40db385ad47dcaf32678dbd9ba635e", "id": 10}], "next_curs": "ClESS2oVc35sYXdpbnNpZGVyY29udHJhY3Rzci0LEhZDbGF1c2VTbmlwcGV0R3JvdXBfdjU2IhFkaWFseXNpcyMwMDAwMDAwYQyiAQJlbhgAIAA=", "clause": {"children": [["", ""], ["recall", "Recall"], ["part-time-only", "Part-time Only"], ["summer-vacation-procedure", "Summer Vacation Procedure"], ["vacations", "\u2013 VACATIONS"]], "parents": [["substance-abuse-services", "Substance Abuse Services"], ["rehabilitation", "Rehabilitation"], ["occupational-therapy", "OCCUPATIONAL THERAPY"], ["benefits-under-the-policy", "BENEFITS UNDER THE POLICY"], ["medical-covers", "Medical Covers"]], "title": "Dialysis", "size": 52, "id": "dialysis", "related": [["dialysis-services", "Dialysis Services", "<strong>Dialysis</strong> Services"], ["chiropractic-services", "Chiropractic Services", "Chiropractic Services"], ["animals", "Animals", "Animals"], ["diagnostic", "Diagnostic", "Diagnostic"], ["hospital", "Hospital", "Hospital"]], "related_snippets": [], "updated": "2025-07-07T12:37:39+00:00"}, "json": true, "cursor": ""}}