Other Medical Services Sample Clauses

Other Medical Services. In addition to PCPs, specialists, and hospitals, the network includes other health care professionals to meet your needs. If you need diagnostic testing, laboratory services or other health care services, your PCP or participating OB/GYN will coordinate your care or refer you to an appropriate setting. You may have to pay a copayment and any other applicable coinsurance or deductibles for some of these services, depending on your plan. Preventive Care Preventive care is a key part of your plan, which emphasizes staying healthy by covering: • Well-child care, including immunizations • Prenatal and postnatal careHearing loss screenings through 24 months • Periodic health assessments • Eye and ear screenings • Annual well-woman exams, including, but not limited to, a conventional Pap smear • Annual screening mammograms for females age 35 and over, or females with other risk factorsBone mass measurement for osteoporosis • Prostate cancer screening for males at least age 50, or at least age 40 with a family history of prostate cancer • Colorectal cancer screening for persons 50 years of age and older • Depending on your plan, any other evidence-based items or services that have in effect a rating of “A” or “B” in the current recommendations of the United States Preventive Task Force (“USPSTF”) or as required by state law. Your mental health benefits include outpatient and depending on your plan inpatient visits for crisis intervention and evaluation. Please refer to your COC for additional information. To access mental health services, call the designated behavioral health vendor listed on the back of your ID card. Prescription Drugs Depending on your plan, you may have coverage for prescription drugs. To find out which prescription drugs are covered under a plan, you can review the applicable drug list at xxx.xxxxxx.xxx/xxxxxx/xx_xxxxx.
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Other Medical Services. All other SoonerCare benefits, with the exception of emergency transportation which is paid through a capitated contract, are paid through the state’s FFS system.
Other Medical Services. In addition to PCPs, specialists, and hospitals, the network includes other health care professionals to meet your needs. If you need diagnostic testing, laboratory services or other health care services, your PCP or participating OB/GYN will coordinate your care or refer you to an appropriate setting. You may have to pay a copayment and any other applicable coinsurance or deductibles for some of these services, depending on your plan.
Other Medical Services. 1. Inpatient medical care visits.
Other Medical Services. The services of ABG further include other medical services, including the following: • Primary care office hours, including physical therapy with infrared light therapy, inhalation therapy and drug therapy for minor infections, sprains, etc. provided that the medications are available in stock • Vaccinations • Pre-employment medical examinations, including medical examinations of minors as provided for under the German Youth Protection Act • Training of first aid personnel of ATB
Other Medical Services. The Practice will also provide general internal medicine and cardiology services to you as a regular patient of the Practice, but such medical services will be arranged directly between you and the Practice, will be paid for by you directly, by your insurance company, or by Medicare (as the case may be) and are not covered by this Agreement. (As used in this Agreement, the term “Insurance Company” or “Insurance” will mean your private health insurance policy or your individual or group health plan, HMO, PPO, or other similar private health plan or coverage.) You or your Insurance Company (or Medicare, as the case may be) will be financially responsible to pay for all medical services. You acknowledge that the fee paid under this Agreement does not affect the co- payments, co-insurance, or deductibles that you are required to pay pursuant to the terms of any Insurance contract or medical coverage, including Medicare. You will continue to be responsible for any co-payments, co-insurance, and/or deductible amounts required by your Insurance coverage or Medicare for medical services.
Other Medical Services. The charged amount of medical hours in connection with all other Medical Services is de- pendent on the time expenditure of the Health Professionals or is based on a flat fee for the respective Medical Service. The current prices for Fee-based Medical Services are published under: [here].
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Other Medical Services. During the term of a Physician ---------------------- Member's Employment Agreement and thereafter subject to Section 8.1, a Physician Member shall not (directly or as an employee, shareholder, partner, consultant or otherwise) acquire. establish or commence the operation of any medical office, ambulatory surgery center, Integrated Health Service, optical shop, health maintenance organization. preferred provider organization, exclusive provider organization or similar entity or organization without the prior approval of the Joint Policy Board and PQC.

Related to Other Medical Services

  • Paramedical Services Services of the following registered/certified practitioners up to the maximums shown on the "Summary of Benefits" pages:

  • Medical Services We do not Cover medical services or dental services that are medical in nature, including any Hospital charges or prescription drug charges.

  • Surgical Services All necessary procedures for extractions and other surgical procedures normally performed by a dentist.

  • Medical Services Plan 10.1.1 Regular Full-Time and Temporary Full-Time Employees shall be entitled to be covered under the Medical Services Plan commencing the first day of the calendar month following the date of employment.

  • Technical Services Party B will provide technical services and training to Party A, taking advantage of Party B’s advanced network, website and multimedia technologies to improve Party A’s system integration. Such technical services shall include:

  • Pharmacy Services The Contractor shall establish a network of pharmacies. The Contractor or its PBM must provide at least two (2) pharmacy providers within thirty (30) miles or thirty (30) minutes from a member’s residence in each county, as well as at least two (2) durable medical equipment providers in each county or contiguous county.

  • ELECTRICAL SERVICES A. Landlord shall provide electric power for a combined load of 3.0 xxxxx per square foot of useable area for lighting and for office machines through standard receptacles for the typical office space.

  • Surgery Services This plan covers surgery services to treat a disease or injury when: • the operation is not experimental or investigational, or cosmetic in nature; • the operation is being performed at the appropriate place of service; and • the physician is licensed to perform the surgery. Preauthorization may be required for certain surgical services. Reconstructive Surgery for a Functional Deformity or Impairment This plan covers reconstructive surgery and procedures when the services are performed to relieve pain, or to correct or improve bodily function that is impaired as a result of: • a birth defect; • an accidental injury; • a disease; or • a previous covered surgical procedure. Functional indications for surgical correction do not include psychological, psychiatric or emotional reasons. This plan covers the procedures listed below to treat functional impairments. • abdominal wall surgery including panniculectomy (other than an abdominoplasty); • blepharoplasty and ptosis repair; • gastric bypass or gastric banding; • nasal reconstruction and septorhinoplasty; • orthognathic surgery including mandibular and maxillary osteotomy; • reduction mammoplasty; • removal of breast implants; • removal or treatment of proliferative vascular lesions and hemangiomas; • treatment of varicose veins; or • gynecomastia. Preauthorization may be required for these services.

  • Legal Services If this Agreement is for legal services, this section is applicable. Contractor shall: (i) adhere to legal cost and billing guidelines designated by the JBE; (ii) adhere to litigation plans designated by the JBE, if applicable; (iii) adhere to case phasing of activities designated by the JBE, if applicable; (iv) submit and adhere to legal budgets as designated by the JBE; (v) maintain legal malpractice insurance in an amount not less than the amount designated by the JBE; and (vi) submit to legal bill audits and law firm audits if so requested by the JBE, whether conducted by employees or designees of the JBE or by any legal cost-control provider retained by the JBE for that purpose. Contractor may be required to submit to a legal cost and utilization review as determined by the JBE. If (a) the Contract Amount is greater than $50,000, (b) the legal services are not the legal representation of low- or middle-income persons, in either civil, criminal, or administrative matters, and (c) the legal services are to be performed within California, then Contractor agrees to make a good faith effort to provide a minimum number of hours of pro xxxx legal services, or an equivalent amount of financial contributions to qualified legal services projects and support centers, as defined in section 6213 of the Business and Professions Code, during each year of the Agreement equal to the lesser of either (A) thirty (30) multiplied by the number of full time attorneys in the firm’s offices in California, with the number of hours prorated on an actual day basis for any period of less than a full year or (B) the number of hours equal to ten percent (10%) of the Contract Amount divided by the average billing rate of the firm. Failure to make a good faith effort may be cause for nonrenewal of this Agreement or another judicial branch or other state contract for legal services, and may be taken into account when determining the award of future contracts with a Judicial Branch Entity for legal services.

  • Dental Services The following dental services are not covered, except as described under Dental Services in Section 3: • Dental injuries incurred as a result of biting or chewing. • General dental services including, but not limited to, extractions including full mouth extractions, prostheses, braces, operative restorations, fillings, frenectomies, medical or surgical treatment of dental caries, gingivitis, gingivectomy, impactions, periodontal surgery, non-surgical treatment of temporomandibular joint dysfunctions, including appliances or restorations necessary to increase vertical dimensions or to restore the occlusion. • Panorex x-rays or dental x-rays. • Orthodontic services, even if related to a covered surgery. • Dental appliances or devices. • Preparation of the mouth for dentures and dental or oral surgeries such as, but not limited to, the following: o apicoectomy, per tooth, first root; o alveolectomy including curettage of osteitis or sequestrectomy; o alveoloplasty, each quadrant; o complete surgical removal of inaccessible impacted mandibular tooth mesial surface; o excision of feberous tuberosities; o excision of hyperplastic alveolar mucosa, each quadrant; o operculectomy excision periocoronal tissues; o removal of partially bony impacted tooth; o removal of completely bony impacted tooth, with or without unusual surgical complications; o surgical removal of partial bony impaction; o surgical removal of impacted maxillary tooth; o surgical removal of residual tooth roots; and o vestibuloplasty with skin/mucosal graft and lowering the floor of the mouth. Dialysis Services • The following dialysis services received in your home: o installing or modifying of electric power, water and sanitary disposal or charges for these services; o moving expenses for relocating the machine; o installation expenses not necessary to operate the machine; and o training in the operation of the dialysis machine when the training in the operation of the dialysis machine is billed as a separate service. • Dialysis services received in a physician’s office.

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