Outpatient Surgery Sample Clauses

Outpatient Surgery. A $100 single and $200 family combined annual deductible will apply to Outpatient Surgery after which 100% Coverage will apply.
AutoNDA by SimpleDocs
Outpatient Surgery. 6. Any absence for which the District is required to provide a reasonable accommodation
Outpatient Surgery. Discipline issued to employees under the Sick Day Policy carries over from fiscal year to fiscal year. However, if an employee goes twelve (12) consecutive months without incurring any discipline under the Sick Day Policy, the disciplines he or she has will be removed from consideration; and the employee will start over on progressive discipline. Any District authorized exceptions would be in writing and available for the Union President to review.
Outpatient Surgery. Procedures including all routine Medical Services required during the 12 Outpatient Visit including but not limited to all medical supplies, central service items, and nursing 13 support or care.
Outpatient Surgery. This includes any diagnostic or therapeutic sur- xxxx prescribed and carried out by a specialist in the relevant area included in the Insurer’s Direc- tory of Practitioners at an authorised healthcare facility, that normally requires an operating the- atre. A waiting period of 6 months is established for this type of Surgery. Prior referral and authorisation by the Insurer are required. Siempre que el parto/cesárea haya sido cubier- to por ASISA, la hospitalización del recién nacido será de cobertura con cargo al contrato de segu- ro de la madre, hasta un máximo de 30 xxxx des- de la fecha de su nacimiento; para continuidad asistencial a cargo de la Entidad, es imprescin- xxxxx el xxxx del recién nacido en ASISA dentro del citado período, según lo previsto en el apar- tado c) de la Condición General Octava. - Hospitalización por motivo quirúrgico. Ade- más de los gastos de la intervención quirúrgi- ca, incluye también el estudio preoperatorio así como las visitas y curas en el postoperatorio inmediato, así como las prótesis o implantes in- cluidas de forma expresa en el punto 10 de esta condición Segunda. - Hospitalización por motivo médico (que no precisa intervención quirúrgica). Para tratamiento de los procesos que, a juicio del especialista del Cuadro Médico, no puedan tra- tarse en el domicilio o de forma ambulatoria con las técnicas correctas y precisen internamiento. - Hospitalización Psiquiátrica: En régimen de in- greso de Hospital de Día y para tratamiento de pacientes con procesos psiquiátricos agudos o crónicos reagudizados y que xxxx recuperables. En estos casos no se incluye cama de acompa- ñante. Se establece una limitación de 50 xxxx de Hospitalización por anualidad de seguro. - Hospitalización en unidades especializadas, como Unidad de Vigilancia Intensiva (U.V.I.) o Unidad Coronaria. En estos casos no se incluye cama de acompañante. Para cualquier Hospitalización se establece un Periodo de Carencia de 8 meses (salvo situacio- nes de Urgencia o partos prematuros).
Outpatient Surgery. 100% Coverage
Outpatient Surgery. Outpatient surgery may be performed in an Acute Care Hospital or Ambulatory Surgical Facility. Benefits for Ambulatory Surgical Facilities include those outpatient surgeries that, in the judgment of the Provider, are nonlife threatening, can be provided in a facility other than an Acute Care Hospital, and are performed at an Ambulatory Surgical Facility by a duly licensed associated Physician or allied health professional practicing within the scope of his/her licensure and specialty. Outpatient surgeries performed in an Acute Care Hospital may be subject to higher Cost Sharing Amounts.
AutoNDA by SimpleDocs
Outpatient Surgery. Section 7 Employees who have accrued in excess of fifteen (15) sick days may use any such excess sick days during the winter break period and during spring break period (i.e., Special Holiday). Employees who choose to apply their excess sick days to winter and/or spring break must submit a written request to their supervisor in advance of the break period. Discipline issued to employees under the Sick Day Policy carries over from school year to school year. However, if an employee goes 75 work days without incurring any discipline, he/she shall have one occurrence removed from consideration. Thereafter, for each successive 75 work day period which passes without the occurrence of any discipline, an additional occurrence shall be removed from consideration. In the event twelve (12) consecutive months pass without incurring any discipline under the Sick Day Policy, all the disciplines he/she has will be removed from consideration, and the employee will start over on progressive discipline. Any District-authorized exceptions shall be in writing and available for the Union to review.
Outpatient Surgery. Case Rates ------------------- Arthroscopies $[ ** ] Laparoscopic Procedures $[ ** ] Lithotripsy $[ ** ] Fractures of Hips and Pelvis $[ ** ] Cardiac Pacemaker Device Replacement $[ ** ] Inguinal Hernia $[ ** ] Breast Biopsy w/ or w/o Localization $[ ** ] Cataract w/IOI $[ ** ] Cataract w/Lens $[ ** ] Bunionectomy $[ ** ] Other Outpatient Surgical Procedures [ ** ] ATTACHMENT A4-1 HOSPITAL SERVICES VALUATION SCHEDULE ST JUDE MEDICAL CENTER PROSPECT MEDICAL GROUP PAGE 2 Exclusions: (Reimbursed Separately) --------------------------------- Excluded from Case Rates and/or per diems Prosthesis/Implants/DME/Chole-K/ [ ** ] Pacemakers/Valves/Balloon Catheters/ DCA cutting Devices/Imaging Catheters Emergency Room: $0-$300 in Gross Charges [ ** ] $301 and greater [ ** ] Risk Pool Distribution: St. Jude Medical Center [ ** ] Prospect Medical Group [ ** ] Limited Downside Risk-Prospect Med Group [ ** ] St. Jude Medical Center Stop Loss Reinsurance [ ** ] BED DAYS BONUS SCHEDULE Bed Days/Thousand: Total member months Bonus ------------------ ------ 1,200 or greater [ ** ] 1,000 to 1,199 [ ** ] 951 to 999 [ ** ] 900 to 950 [ ** ] 850 to 899 [ ** ] 800 to 849 [ ** ] 700 to 799 [ ** ] 600 to 699 [ ** ] Under 600 [ ** ] 41a ATTACHMENT B SECURE HORIZONS MEDICAL AND HOSPITAL SUBSCRIBERS AGREEMENT Secure Horizons Medical and Hospital Subscriber Agreement is available upon request. A summary of the Schedule of Benefits is attached. ATTACHMENT C COMPENSATION CAPITATION PAYMENTS - PacifiCare shall make monthly Capitation Payments to IPA based on the number of Subscribers eligible to receive Medical Services from IPA.
Outpatient Surgery. We will provide benefits for Surgery, abortion services, sterilizations and one attempt at reversal of sterilization. These services are subject to prior authorization. You must pay the Cost Share listed on your Schedule for each surgery. Voluntary sterilization procedures for females are covered with no Cost Share. Voluntary sterilization procedures for males are subject to the deductible for members in plans that are titled “MVP High Deductible” (an IRS HSA Qualified High Deductible Health Plan).
Time is Money Join Law Insider Premium to draft better contracts faster.