Common use of Prescription Drugs Clause in Contracts

Prescription Drugs. The agreement may impose a variety of limits affecting the scope or duration of benefits that are not expressed numerically. An example of these types of treatments limit is preauthorization. Preauthorization is applied to behavioral health services in the same way as medical benefits. The only exception is except where clinically appropriate standards of care may permit a difference. Mental disorders are covered under Section A. Mental Health Services. Substance use disorders are covered under Section

Appears in 16 contracts

Samples: Subscriber          Agreement, Subscriber          Agreement, Subscriber          Agreement

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Prescription Drugs. The agreement may impose a variety of limits affecting the scope or duration of benefits that are not expressed numerically. An example of these types of treatments limit is preauthorization. Preauthorization is applied to behavioral health services in the same way as medical benefits. The only exception is except where clinically appropriate standards of care may permit a difference. Mental disorders are covered under Section A. Mental Health Services. Substance use abuse disorders are covered under SectionSection B. Substance abuse Treatment.

Appears in 14 contracts

Samples: Subscriber Agreement, Subscriber Agreement, Subscriber          Agreement

Prescription Drugs. The agreement may impose a variety of limits affecting the scope or duration of benefits that are not expressed numerically. An example of these types of treatments limit is preauthorization. Preauthorization Preauthorization, concurrent utilization review and retrospective utilization review is applied to behavioral health services in the same way as medical benefits. The only exception is except where clinically appropriate standards of care may permit a difference. Mental disorders are covered under Section A. Mental Health Services. Substance use disorders are covered under SectionSection B. Substance Use Disorder Treatment.

Appears in 10 contracts

Samples: Subscriber        Agreement, Subscriber Agreement, Subscriber Agreement

Prescription Drugs. The agreement may impose a variety of limits affecting the scope or duration of benefits that are not expressed numerically. An example of these types of treatments limit is preauthorization. Preauthorization Preauthorization, concurrent utilization review, and retrospective utilization review is applied to behavioral health services in the same way as medical benefits. The only exception is except where clinically appropriate standards of care may permit a difference. Mental disorders are covered under Section A. Mental Health Services. Substance use disorders are covered under SectionSection B. Substance Use Disorder Treatment.

Appears in 5 contracts

Samples: Subscriber Agreement, Subscriber Agreement, Subscriber Agreement

Prescription Drugs. The agreement may impose a variety of limits affecting the scope or duration of benefits that are not expressed numerically. An example of these types of treatments limit is preauthorization. Preauthorization is applied to behavioral health services in the same way as medical benefits. The only exception is except where clinically appropriate standards of care may permit a difference. Mental disorders are covered under Section A. Mental Health Services. Substance use abuse disorders are covered under Sectionunder

Appears in 5 contracts

Samples: Subscriber          Agreement, Subscriber          Agreement, Subscriber Agreement

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Prescription Drugs. The agreement may impose a variety of limits affecting the scope or duration of benefits that are not expressed numerically. An example of these types this type of treatments treatment limit is preauthorization. Preauthorization is applied to behavioral health services in the same way as medical benefits. The only exception is except where clinically appropriate standards of care may permit a difference. A network authorization must be obtained prior to receiving services from an out-of-network provider. Mental disorders are covered under Section A. Mental Health Services. Substance use disorders are covered under Section

Appears in 1 contract

Samples: Subscriber Agreement

Prescription Drugs. The agreement may impose a variety of limits affecting the scope or duration of benefits that are not expressed numerically. An example of these types of treatments limit is preauthorization. Preauthorization is applied to behavioral health services in the same way as medical benefits. The only exception is except where clinically appropriate standards of care may permit a difference. Mental disorders are covered under Section A. Mental Health Services. Substance use disorders are covered under SectionSection B. Substance Use Disorder Treatment.

Appears in 1 contract

Samples: Subscriber Agreement

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