Surgical Services. Benefits will be provided for surgical services consisting of operative and cutting procedures (including the usual post-operative care). Such services may be performed in or out of a Hospital by a Physician. Certain operations and procedures require a review by the Utilization Review Agent as described in Section V. A. If the services are performed out of a Hospital, the Co-Payment and coverage level will be determined on the basis of the type of facility (Outpatient Surgical Facility or Physician's office) in which the surgical services are performed. Additional benefits will be provided as follows:
Appears in 5 contracts
Samples: Insurance Agreement, Insurance Agreement, Insurance Agreement
