Surgery Services Sample Clauses

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.
Surgery Services. For diagnostic imaging, lab, and machine tests see Section 3.37.
Surgery Services. For a specialist exam, see Section 3.24 - Office Visits. For diagnostic imaging, lab and machine tests see Section 3.37. See the Summary of Medical Benefits for benefit limits and the amount that you pay for each type of service. If you are admitted to a non-network hospital from the emergency room, BCBSRI recommends you obtain preauthorization to receive inpatient services. Call our Customer Service Department at (401) 459-5000 or 1-800-639-2227 with any questions you have about your coverage. Follow-up care (such as suture removal, fracture care or wound care) should be obtained from your primary care physician or a specialist.
Surgery Services. If you are admitted to a general hospital as an inpatient for a medical condition, we cover the services of a doctor in charge of your medical care, up to one (1) visit per day. If you are admitted for surgical, obstetrical, or radiation services, our allowance to the doctors who performed your surgery, delivered your child, or supervised your radiation includes payment for all your related hospital visits by these doctors during your admission. If, while you are in the hospital, the attending doctor in charge of your care asks for the assistance of a doctor who has special skills and knowledge to diagnose your condition, we cover a consultation performed by a specialist. The transferring of a patient from one doctor to another is not considered to be a consultation. A specialized doctor who then treats you as his or her patient is not considered to be a consultant If you need inpatient specialty care for a condition that requires skills the doctor in charge of your care does not have, we will cover specialist visits as medically necessary.
Surgery Services. Inpatient doctor services 0% - After Deductible 20% - After Deductible Outpatient doctor services 0% - After Deductible 20% - After Deductible In a doctor’s office 0% 20% - After Deductible Telemedicine Telemedicine services When rendered by a designated provider. $20 Not Covered Tests, Imaging, and Labs (includes machine tests and x-rays) (Diagnostic) Outpatient/in a doctor’s office/urgent care center or free- standing laboratory: MRI*, MRA*, CAT scans*, CTA scans*, PET scans*, nuclear cardiac imaging* and sleep studies.* 0% - After Deductible 20% - After Deductible Diagnostic imaging and machine tests, other than the diagnostic imaging services listed above. Copayment is per provider per day. 0% 20% - After Deductible Lab and pathology services. 0% 20% - After Deductible Covered Benefits Network Providers You Pay Non-network Providers You Pay See Section 3.0 – Covered Health Care Services for additional benefit limits and coverage information. Diagnostic colorectal services (Including, but not limited to, fecal occult blood testing, flexible sigmoidoscopy, colonoscopy, and barium enema. See Prevention and Early Detection Services for preventive colorectal services.) 0% - After Deductible 20% - After Deductible Lyme disease-diagnosis 0% - After Deductible 20% - After Deductible
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.
Surgery Services. For a specialist exam, see Section 3.23 - Office Visits. For diagnostic imaging, lab and machine tests see Section 3.35. See the Summary of Medical Benefits for benefit limits and the amount that you pay for each type of service. If you are admitted to a non-network hospital from the emergency room to receive inpatient services call our Customer Service Department at (401) 459-5000 or 1-800-639-2227 with any questions you have about your coverage. Suture removal, performed where the original emergency services were received, is covered as part of our allowance for the original emergency treatment. We will ONLY cover a separate charge for suture removal if the suturing and suture removal are performed at different locations (i.e. sutures at emergency room and suture removal at doctor’s office).
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.
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.
Surgery Services. For diagnostic imaging, lab and machine tests see Section 3.34.