Radiology Services Sample Clauses

Radiology Services. Covered when medically necessary as ordered by a qualified medical professional, and when ordered and provided by a qualified medical professional/practitioner. EPSDT Services/Child EPSDT is a package of early and periodic screening, Services not included in the managed Teen Health Program including inter-periodic screens and, diagnostic and care Benefit Package ordered by the (C/THP) treatment services that are offered to all Medicaid child's physician based on the eligible children under twenty-one (21) years of age results of a screening. known in New York State as the Child Teen Health Program (C/THP). APPENDIX K October 1, 2004 K-5 COVERED SERVICES MANAGED CARE PLAN SCOPE OF BENEFIT COVERED BY MEDICAID FEE-FOR-SERVICE Home Health Services Home health care services include medically necessary Services rendered by a personal care nursing, home health aide services, equipment and appliances, agency which are approved by the Local physical therapy, speech/language pathology, occupational Social Services District when ordered therapy, social work services or nutritional services by the Enrollee's Primary Care provided by a home health care agency pursuant to an Provider (PCP). The district will established care plan. Personal care tasks performed by a determine the applicant's need for home health aide in connection with a home health care agency personal care agency services and visit, and pursuant to an established care plan, are covered. coordinate a plan of care with the personal care agency. Private Duty Nursing Covered service when medically necessary in accordance with Services the ordering physician, registered physician assistant or certified nurse practitioner's written treatment plan. Emergency Room Services Covered for emergency conditions, medical or behavioral, the onset of which is sudden, manifesting itself by symptoms of sufficient severity, including severe pain, that a prudent layperson, possessing an average knowledge of medicine and health, could reasonably expect the absence of medical attention to result in (a) placing the health of the person afflicted with such condition in serious jeopardy, or in the case of a behavioral condition placing the health of such person or others in serious jeopardy; (b) serious impairment of such person's bodily functions; (c) serious dysfunction of any bodily organ or part of such person; or (d) serious disfigurement of such person. Emergency services include health care procedures, treatments or serv...

Radiology Services. Radiology tests that are listed in EXHIBIT B, provided through the scope of primary care services at the clinic location, and performed and read by a physician at the primary care clinic are included in the radiology flat fee. Radiology tests that are not listed in EXHIBIT B, are performed at locations other than the clinics in this agreement, or are referred for reading to a radiologist are not covered under the flat fee. These will be billed as a regular medical claim that will take into account the deductible and co-insurance factor when adjudicated by BCBS. Examples of radiology services not provided under this clinic arrangement are MRI scans, CT scans, bone density scans, and mammograms.

Radiology Services. Radiology services provided in the physician’s office, outpatient facility, or inpatient hospital facility are covered. Advanced radiology services are covered for the diagnosis and ongoing medical management of an illness or injury. Examples of advanced radiology procedures include, but are not limited to, CT scan, PET scan, magnetic resonance imaging (MRI), magnetic resonance angiography (MRA) and nuclear scans.‌‌ Plastic and reconstructive surgical services are covered only as described below. • Reconstructive surgical services following a mastectomy or lymph node dissection are covered. The length of a hospital stay associated with a mastectomy or lymph node dissection is determined by the attending physician and surgeon in consultation with the patient, consistent with sound clinical principles and processes. There is no prior Authorization required in determining the length of hospital stay following these procedures. Members who elect to have breast reconstruction after a mastectomy are covered for all complications of the mastectomy and reconstructive surgery, prostheses for and reconstruction of the affected breast, and reconstructive surgery on the other breast as may be needed to produce a symmetrical appearance. • Reconstructive surgical services, performed on abnormal structures of the body caused by congenital defects, developmental anomalies, trauma, infection, tumors, disease or Medically Necessary dental or orthodontic services that are an integral part of reconstructive surgery for cleft palate procedures are covered when performed to improve function or create a normal appearance, to the extent possible. • For gender dysphoria, reconstructive surgery of primary and secondary sex characteristics to improve function, or create a normal appearance to the extent possible, for the gender with which the Member identifies, in accordance with the standard of care as practiced by physicians specializing in reconstructive surgery who are competent to evaluate the specific clinical issues involved in the care requested. The Cost Share for reconstructive surgical services is determined based on the type and location of the service. Please see the Summary of Benefits. Skilled Nursing Facility services are covered for up to a maximum of 100 days per benefit period in a semi-private room (unless a private room is Medically Necessary). Covered Benefits for skilled nursing care are those services prescribed by a Plan Provider and provided in a qualified li...

Radiology Services. 5.37.1. CONTRACTOR shall provide Radiology Services for all medically necessary and appropriate diagnostic X-ray procedures, subject to the prior approval of the DC’s Office of Health Services. All services shall be provided in accordance with Florida Statute, Florida Administrative Code, DC policy and procedures, HSB and local regulations for equipment and personnel licensure. 5.37.2. CONTRACTOR shall ensure that X-ray films are read by a radiologist. The radiologist shall call the Facility CHO/ARNP with any report requiring immediate intervention. CONTRACTOR shall ensure that a written report, on the appropriate DC form, is forwarded as required. All emergency X-rays that are required at times other than normal working hours shall be performed at a local facility. A physician shall review, initial and date all X-ray reports within a reasonable time.

Radiology Services. CONTRACTOR shall provide Radiology Services for all medically necessary and appropriate diagnostic X-ray procedures. 5.36.1. All services shall be provided in accordance with applicable state and local regulations for equipment and personnel licensure. 5.36.2. CONTRACTOR shall ensure that X-ray films are read by a radiologist. The radiologist shall call the Facility CHO/ARNP with any report requiring immediate intervention. CONTRACTOR shall ensure that a written report, on the appropriate FDC form, is forwarded as required. All emergency X- rays that are required at times other than normal working hours shall be performed at a local Facility. A physician shall review, initial and date all X- ray reports.

Radiology Services diagnostic and therapeutic

Radiology Services. The Institution hereby acknowledges , that the Radiologist shall be included in the Study Staff, under employment of the Institution and who will be responsible for performance of activities stipulated to him/her by Study Protocol. Remuneration of the Radiologist shall be provided in terms of a separate agreement concluded between the Principal Investigator and Quintiles/Sponsor.

Radiology Services. 1. The Contractor shall provide medically necessary and appropriate diagnostic X-ray procedures. 2. The Contractor shall be financially responsible for all radiology services. Routine x-rays may be provided on-site if the Contractor elects to equip and maintain an x-ray department, since the Department does not own any x-ray equipment. If the Contractor chooses not to equip an x-ray department, the Contractor may provide routine or non-urgent x-rays through the Department's contracted provider or under a written subcontracting arrangement with a provider approved in writing by the Department. The most cost-effective process may be utilized subject to the prior approval of the Contract Manager. All services shall be provided in accordance with applicable state and local regulations for equipment and personnel licensure. 3. The Contractor shall provide all fluoroscopy, magnetic imaging, CAT scan, ultrasound and other special studies for all inmates. 4. The Contractor shall ensure that x-ray films are read by a radiologist. The radiologist shall call the institution's CHO with any report requiring immediate intervention. The Contractor shall ensure that a written report, on form DC4-705A, is forwarded to the institution within 24 hours of interpretation of the films. All emergency x-rays that are required at times other than normal working hours shall be performed at a local facility. A physician shall review, initial and date all x-ray reports within five (5) days.

Radiology Services. 6.11.1. The Contractor is responsible for entering requests for Radiology procedures into VISTA utilizing CPRS. X-rays shall be performed by the Contractor on site at the CBOC, using Contractor provided radiology equipment approved by VAPHS Radiation Safety Officer (RSO), and will be interpreted by VAPHS Certified Radiologists. All radiographic images will be sent by Computerized Radiography (CR) Reader, supplied by VAPHS, to VISTA Imaging and the Philips Picture Archiving and Communications System (PACS) via a Digital Image and Communication in Medicine (DICOM) (3.0) send. 3.6.11.2. All images shall be stored in VISTA Imaging and which is considered part of the patient’s electronic record. These images shall be a result of direct digital (DR) or computed radiography (CR) acquisition and cannot be from a DICOM film digitizer. 3.6.11.3. These images shall be case edited by the technologists, and sent to VISTA Imaging/Stentor PACS within two (2) hours of completion. All images shall be stored within VISTA Imaging and become part of the patient’s electronic record. All x-ray requests that are STAT, urgent, or from the Emergency Department shall be interpreted within forty five (45) minutes after completion of the exam. 3.6.11.4. All X-rays performed at the contractor’s facility will be stored on the contractors PACS system and sent to VAPHS radiology department for uploading in to the PACS /VISTA imaging system. 3.6.11.5. All x-rays performed on site will be interpreted by Radiologists at VAPHS, University Drive Division, within one (1) working day of receipt. X-ray interpretation reports will be available in VA's VISTA/CPRS computer system within two (2) working days of receipt. 3.6.11.6. X-rays performed at VA or at CBOC site can be viewed by the Contractor through VISTA Imaging and the Philips PACS. 3.6.11.7. Contractor is responsible for all daily/weekly quality assurance of imaging equipment as determined by the manufacturer and for repairs and maintenance of that equipment.