Medical Care. Medical Care rendered by a Participating Professional Provider in charge of the Member’s case while an Inpatient in a Participating Facility Provider that is a Hospital, Rehabilitation Hospital or Skilled Nursing Facility for a condition not related to Surgery or pregnancy, or except as specifically provided. Such care includes Inpatient intensive Medical Care rendered to a Member while their condition requires a Referred Specialist's constant attendance and treatment for a prolonged period of time. 1. Concurrent Care Services rendered to a Member while an Inpatient in a Participating Facility Provider that is a Hospital, Rehabilitation Hospital or Skilled Nursing Facility by a Referred Specialist who is not in charge of the case but whose particular skills are required for the treatment of complicated conditions. This does not include observation or reassurance of the Member, standby services, routine preoperative physical exams or Medical Care routinely performed in the pre- or post-operative or pre- or post- natal periods or Medical Care required by the Participating Facility Provider's rules and regulations.
Appears in 8 contracts
Sources: Individual Hmo Subscriber Agreement, Individual Hmo Subscriber Agreement, Hmo Subscriber Agreement