Emergency Admissions. Emergency inpatient hospital confinements including inpatient psychiatric treatment must be certified within 48 hours of admission or a ten percent (10%) penalty will be applied to total charges in addition to the deductible, coinsurance and out-of-pocket maximum. In the event the care is provided by a non-network provider and is determined to be medically unnecessary, the employee will be responsible for the cost of all such medically unnecessary care.
Emergency Admissions. Effective January 1, 2018, an emergency room visit will be subject to a seventy-five dollar ($75.00) co-pay per visit and twenty percent (20%) co-insurance after the co-pay and deductible. If admitted, the co-pay will be waived.
Emergency Admissions. 1. In case of emergencies also, the procedure specified in Clause (I) (1), (2) and (3) shall be followed.
Emergency Admissions. 7.1 In the case of an emergency admission the Care Provider may accept a Service User before a CSO has been completed and accepted by the Care Provider. In such cases the placement shall be deemed to have been made in accordance with the terms, conditions, specifications and standards contained in this Agreement or any variation thereof agreed in writing between the parties and a CSO shall be completed as authorisation by the parties as soon as it is reasonably practicable.
Emergency Admissions. If you must be hospitalized in a Non-Plan Hospital or Non- Participating Hospital immediately following Emer- gency Accident Care or Emergency Medical Care, benefits will be provided at the Participating Provider Hospital payment level for that portion of your Inpatient Hospital stay during which your condition is reasonably deter- mined by Blue Cross and Blue Shield to be serious and therefore not permitting your safe transfer to a Participat- ing Hospital or other Participating Provider. For that portion of your Inpatient Hospital stay during which your condition is reasonably determined by Blue Cross and Blue Shield not to be serious, benefits will be provided at 50% of the Eligible Charge for Covered Ser- vices if you are in a Non-Plan Hospital or at the Non- Participating Provider Hospital payment level, if you are in a Non-Participating Hospital. In order for you to continue to receive benefits at the Participating Hospital payment level following an emergency admission to a Non-Plan or Non-Participating Hospital, you must transfer to a Participating Hospital or other Participating Provider as soon as your condition is no longer serious. To identify Plan Hospitals or facilities, you should contact Blue Cross and Blue Shield by calling the customer service toll- free telephone number on your Blue Cross and Blue Shield Identification Card or visit our website at xxx.xxxxxx.xxx.
