OTHER HOSPITAL SERVICES Sample Clauses
OTHER HOSPITAL SERVICES. The following hospital services provided to Central Oregon CCO OHP members will be reimbursed via methods other than the Hospital Capitation Payment:
OTHER HOSPITAL SERVICES a. Devices surgically implanted during a hospital confinement or during an outpatient surgery performed at the Hospital outpatient surgery center or a free-standing surgery center.
b. Treatment programs for outpatient substance abuse as defined by Medicare.
c. Appealed Services - Hospital Services denied by IPA and PacifiCare which are found on appeal or arbitration through the Subscriber grievance resolution process to be Hospital Services which the Subscriber was entitled to have furnished under the PacifiCare Secure Horizons health care delivery system.
d. Chemotherapy Drugs (inpatient and outpatient).
OTHER HOSPITAL SERVICES. (a) Devices surgically implanted (including lenses implanted during cataract surgery) during a hospital confinement or during outpatient surgery performed at the Hospital outpatient surgery department or an ambulatory surgical center.
OTHER HOSPITAL SERVICES a. Devices surgically implanted during a hospital confinement or during an outpatient surgery performed at the Hospital outpatient surgery center or a free-standing surgery center. b. Appealed Services - Hospital Services denied by a Participating Medical Group and PacifiCare which are found on appeal or arbitration through the Subscriber grievance resolution process to be Hospital Services which the Subscriber was entitled to have furnished under the Pacificare Health Plan. c. Chemotherapy Drugs (impatient and outpatient) d. Inpatient and outpatient dialysis (including professional fees) e. Other Health Care Services that must be performed in a hospital or surgicenter (e.g. angiograms)
OTHER HOSPITAL SERVICES a. Devices surgically implanted during a hospital confinement or during an outpatient surgery performed at the Hospital outpatient surgery center or a free-standing ASC.
b. Treatment programs for outpatient substance abuse as defined by Medicare. c. Appealed Services - Hospital Services denied by IPA and PacifiCare which are found on appeal or arbitration through the Subscriber grievance resolution process to be Hospital Services which the Subscriber was entitled to have furnished under the PacifiCare Secure Horizons health care delivery system. d. Chemotherapy Drugs (inpatient and outpatient). e. Self injectable medications