Urgent Care Services. All Medically Necessary Covered Services received in Urgent Care Centers, Retail Clinics or your Primary Care Physician’s office after-hours to treat an Urgent Medical Condition will be covered by AvMed. Any request for reimbursement of payment made by a Member for services received must be filed within 90 days or as soon as reasonably possible but not later than one year unless the Member was legally incapacitated. If Urgent Medical Services and Care are required while outside the continental United States, Alaska or Hawaii, it is the Member’s responsibility to pay for such services at the time they are received. For information on filing a Claim for such services, see Part XIII. REVIEW PROCEDURES AND HOW TO APPEAL A CLAIM (BENEFIT) DENIAL.
Urgent Care Services. (1) The PHO will Provide Urgent Care Services, which are those First Level Services that must be provided urgently because they cannot be safely deferred.
Urgent Care Services. Benefits for services performed in an Urgent Care center include those that, in the judgment of the Provider, are non-life threatening and urgent and can be treated on other than an Inpatient hospital basis and are performed at a freestanding Urgent Care center by a duly licensed associated Physician or allied health professional practicing within the scope of his/her licensure and specialty. Urgent Care services are performed in an ambulatory medical clinic that is open to the public for walk-in, unscheduled visits during all open hours offering significant extended hours, which may include evenings, holidays and weekends.
Urgent Care Services. Benefits are available for Urgent Care received from an Urgent Care center.
Urgent Care Services. 4.6.3.1 The Contractor shall provide Urgent Care services as necessary. Such services shall not be subject to Prior Authorization or Pre-Certification.
Urgent Care Services. Urgent care services are covered when rendered by a participating urgent care center provider for the immediate treatment of a medical condition that requires prompt medical attention but where a brief time lapse before receiving services will not endanger life or permanent health and does not require emergency care services.
Urgent Care Services. The Contractor shall provide Urgent Care services to Members as necessary. Such services shall not be subject to Prior Authorization or Pre-Certification. The Contractor shall provide Demonstration related Urgent Care services to P4HB Participants as necessary. Such services shall not be subject to Prior Authorization or Pre-Certification.
Urgent Care Services. Urgent Care Services are Services required as the result of a sudden illness or injury, which requires prompt attention, but are not of an emergent nature. All Primary Care Plan Physicians are on-call 24/7. When a situation is not an emergency, but requires prompt attention for symptoms such as a sudden rash, high fever, severe vomiting, ear infection or sprain, please call your Primary Care Plan Physician as instructed under Making and Cancelling Appointments and Who to Contact at the beginning of this section.
Urgent Care Services. Note: The copayment for emergency services is waived if you are directly admitted as a hospital inpatient from the emergency department (the hospital copay will apply). Urgent care services ** • At a Xxxxxx Permanente (or Xxxxxx Permanente-designated) urgent care center within the Hawaii service area, for primary care services • At a Xxxxxx Permanente (or Xxxxxx Permanente-designated) urgent care center within the Hawaii service area, with a specialist applicable charges for specialty imaging $15 per visit $20 per visit • At a non-Xxxxxx Permanente facility outside the Hawaii service area 20% of applicable charges Section Benefits You pay Ambulance Ambulan services ce services ** 20% of applicable charges Blood Blood and blood processing ** Applicable cost shares apply. See applicable benefit sections† Mental health Mental health outpatient services, including office visits, day treatment $15 per visit for primary care or services ** and partial hospitalization services $20 per visit with a Specialist Mental health hospital inpatient care, including non-hospital residential services 10% of applicable charges Chemical Chemical dependency outpatient services, including office visits, day $15 per visit for primary care or dependency treatment and partial hospitalization services $20 per visit with a Specialist services ** Chemical dependency hospital inpatient care, including non-hospital residential services and detoxification services 10% of applicable charges Health General health education services **, including diabetes self- $15 per visit for primary care or education management training and education $20 per visit with a Specialist Dependent child coverage While outside of the Xxxxxx Permanente’s service areas, a dependent child is covered per year for the following services: outside the service area ** • Up to 10 office visits for routine primary care $20 per visit • Up to 10 combined outpatient basic laboratory services, basic imaging services, and testing services • Basic laboratory services • Basic imaging services • Testing services $10 per day $10 per day 20% of applicable charges • Up to 10 prescriptions of self-administered drugs 20% of applicable charges Internal prosthetics, devices, Implanted internal prosthetics, including fitting and adjustment of these devices, including repairs and replacement other than those due to misuse or loss Applicable cost shares apply. See applicable benefit sections† and aids ** Durable medical Diabetes equipme...
Urgent Care Services by deleting this section in its entirety and replacing it with the following language: The Contractor shall provide Urgent Care services to Members as necessary. Such services shall not be subject to Prior Authorization or Pre-Certification. The Contractor shall provide Demonstration related Urgent Care services to P4HB Participants as necessary. Such services shall not be subject to Prior Authorization or Pre-Certification.
