Substance Abuse Treatment. This agreement covers medically necessary services for the treatment of substance abuse in a hospital, substance abuse treatment facility, or an acute substance abuse rehabilitation/residential facility that is: reviewed and approved by us; and licensed under the laws of the State of Rhode Island or by the state in which the facility is located as a hospital, a substance abuse treatment facility, or an acute substance abuse residential/rehabilitative facility. We review network and non-network programs, hospital or inpatient facilities, acute substance abuse rehabilitation/residential facilities and the specific services provided. We decide whether a program, hospital or inpatient facility, acute substance abuse rehabilitation/residential facility, or specific services rendered meets our program requirements, content and criteria. If our program requirements, content and criteria are not met, the services are not covered under this agreement. Our program content and criteria are defined below. Inpatient Hospital If you are an acute inpatient in a general or specialty hospital for behavioral health services, we cover medically necessary acute hospital services for detoxification. See Section 3.20 - Inpatient Hospital Services for additional information. Preauthorization is recommended.
Appears in 8 contracts
Samples: Subscriber Agreement, Subscriber Agreement, Subscriber Agreement
Substance Abuse Treatment. This agreement covers medically necessary services for the treatment of substance abuse in a hospital, substance abuse treatment facility, or an acute substance abuse rehabilitation/residential facility that is: • reviewed and approved by us; and • licensed under the laws of the State of Rhode Island or by the state in which the facility is located as a hospital, a substance abuse treatment facility, or an acute substance abuse residential/rehabilitative facility. We review network and non-network programs, hospital or inpatient facilities, acute substance abuse rehabilitation/residential facilities and the specific services provided. We decide whether a program, hospital or inpatient facility, acute substance abuse rehabilitation/residential facility, or specific services rendered meets our program requirements, content and criteria. If our program requirements, content and criteria are not met, the services are not covered under this agreement. Our program content and criteria are defined below. Inpatient Hospital If you are an acute inpatient in a general or specialty hospital for behavioral health services, we cover medically necessary acute hospital services for detoxification. See Section 3.20 - Inpatient Hospital Services for additional information. Preauthorization is recommended.
Appears in 6 contracts
Samples: Subscriber Agreement, Subscriber Agreement, Subscriber Agreement
