Inpatient Detoxification Clause Samples
The Inpatient Detoxification clause defines the terms and conditions under which a patient may receive detoxification services in a hospital or similar inpatient facility. It typically outlines the eligibility criteria, the scope of covered services, and any limitations or requirements such as pre-authorization or medical necessity. This clause ensures that patients who require medically supervised withdrawal from substances can access appropriate care, while also clarifying the extent of coverage and responsibilities of both the provider and the patient, thereby reducing misunderstandings and managing healthcare costs.
Inpatient Detoxification. Detoxification and related medical treatment for Substance Abuse, when provided on an inpatient basis in a hospital which participates in the PPO’s Designated Behavioral Health Benefit Program, or in an inpatient non-hospital facility which participates in the PPO’s Designated Behavioral Health Benefit Program, is covered. The following inpatient Detoxification Services are covered when administered by an employee of the facility: lodging and dietary services; physician, psychologist, nurse, certified addiction counselors and trained staff services; diagnostic x-ray; psychiatric, psychological and medical laboratory testing; drugs, medicines, equipment use and supplies.
Inpatient Detoxification. Detoxification and related medical treatment for Substance Abuse, is covered when provided on an inpatient basis in a hospital, or in an inpatient non-hospital facility, The following inpatient Detoxification Services are covered when administered by an employee of the facility: lodging and dietary services; physician, psychologist, nurse, certified addiction counselors and trained staff services; diagnostic x-ray; psychiatric, psychological and medical laboratory testing; drugs, medicines, equipment use and supplies.
Inpatient Detoxification. Inpatient Covered Services for Detoxification shall be covered for seven (7) days per admission for Detoxification with a Lifetime Maximum of four (4) admissions for Detoxification per Covered Person. Covered Services include:
(1) Lodging and dietary services;
(2) Physician, Psychologist, nurse, certified addictions counselor and trained staff services;
(3) Diagnostic x-rays;
(4) Psychiatric, psychological and medical laboratory testing;
(5) Drugs, medicines, use of equipment and supplies.
Inpatient Detoxification. Covered Medical Services include the following Inpatient services at a Hospital or a Substance Abuse Treatment Facility for detoxification and treatment for medical conditions resulting from the Substance Abuse or Dependency:
(1) lodging and dietary services; (2) Physician, psychologist, nurse, certified addictions counselor and trained staff services; (3) diagnostic x-ray; (4) psychiatric, psychological and medical laboratory testing; (5) drugs, medicines, equipment use and supplies. Each Covered Person is eligible for seven (7) Inpatient days of per calendar year, subject to a lifetime limit of four (4) separate such admissions. Inpatient rehabilitation beyond detoxification in the Hospital is not covered hereunder.
Inpatient Detoxification. Inpatient Covered Services for Detoxification shall be covered for seven (7) days per admission for Detoxification with a Lifetime Maximum of four (4) admissions for Detoxification per Covered Person. Covered Services include:
(1) Lodging and dietary services;
(2) Physician, Psychologist, nurse, certified addictions counselor and trained staff services;
(3) Diagnostic x-rays;
(4) Psychiatric, psychological and medical laboratory testing;
(5) Drugs, medicines, use of equipment and supplies. A Copayment may apply to a Preferred Inpatient Admission, if specified in the Schedule of Benefits. For purposes of calculating the total Copayment due, an admission occurring within ninety (90) days of discharge from a previous admission shall be treated as part of the previous admission