Common use of Urgent Services Clause in Contracts

Urgent Services. The Blue Shield Trio HMO provides coverage for you and your family for your Urgent Service needs when you or your family are temporarily traveling outside of your Primary Care Physician Service Area. Urgent Services are defined as those Covered Ser- vices rendered outside of the Primary Care Physi- cian Service Area (other than Emergency Ser- vices) which are Medically Necessary to prevent serious deterioration of a Member’s health result- ing from unforeseen illness, injury or complica- tions of an existing medical condition, for which treatment cannot reasonably be delayed until the Member returns to the Primary Care Physician Service Area. Out-of-Area Follow-up Care is defined as non- emergent Medically Necessary out-of-area ser- vices to evaluate the Member’s progress after an initial Emergency or Urgent Service. (Urgent Care) While in your Primary Care Physician Service Area If you require urgent, same-day care for a condi- tion that could reasonably be treated in your Pri- xxxx Care Physician’s office or in an urgent care clinic (i.e., care for a condition that is not such that the absence of immediate medical attention could reasonably be expected to result in placing your health in serious jeopardy, serious impairment to bodily functions, or serious dysfunction of any bodily organ or part), you must first call your Pri- xxxx Care Physician. However, you may go di- rectly to an urgent care clinic when your assigned Medical Group/IPA has provided you with instruc- tions for obtaining care from an urgent care clinic in your Primary Care Physician Service Area.

Urgent Services. The Blue Shield Trio Access+ HMO provides coverage for you and your family for your Urgent Service needs when you or your family are temporarily traveling outside of your Primary Care Physician Service Area. Urgent Services are defined as those Covered Ser- vices rendered outside of the Primary Care Physi- cian Service Area (other than Emergency Ser- vices) which are Medically Necessary to prevent serious deterioration of a Member’s health result- ing from unforeseen illness, injury or complica- tions of an existing medical condition, for which treatment cannot reasonably be delayed until the Member returns to the Primary Care Physician Service Area. Out-of-Area Follow-up Care is defined as non- emergent Medically Necessary out-of-area ser- vices to evaluate the Member’s progress after an initial Emergency or Urgent Service. (Urgent Care) While in your Primary Care Physician Service Area If you require urgent, same-day care for a condi- tion that could reasonably be treated in your Pri- xxxx Care Physician’s office or in an urgent care clinic (i.e., care for a condition that is not such that the absence of immediate medical attention could reasonably be expected to result in placing your health in serious jeopardy, serious impairment to bodily functions, or serious dysfunction of any bodily organ or part), you must first call your Pri- xxxx Care Physician. However, you may go di- rectly to an urgent care clinic when your assigned Medical Group/IPA has provided you with instruc- tions for obtaining care from an urgent care clinic in your Primary Care Physician Service Area.

Urgent Services. The Blue Shield Trio Access+ HMO provides coverage cover- age for you and your family for your Urgent Service urgent ser- vice needs when you or your family are temporarily temporar- ily traveling outside of your Primary Care Personal Physician Service Area. Urgent Services are defined as those Covered Ser- vices Services rendered outside of the Primary Care Personal Physi- cian Service Area (other than Emergency Ser- vices) which are Medically Necessary to prevent serious deterioration of a Member’s health result- ing from unforeseen illness, injury or complica- tions of an existing medical condition, for which treatment cannot reasonably be delayed until the Member returns to the Primary Care Personal Physician Service Area. Out-of-Area Follow-up Care is defined as non- emergent Medically Necessary out-of-area ser- vices to evaluate the Member’s progress after an initial Emergency or Urgent Service. (Urgent Care) While in your Primary Care Physician Personal Physi- cian Service Area If you require urgent, same-day urgent care for a condi- tion condition that could reasonably be treated in your Pri- xxxx Care Personal Physician’s office or in an urgent care clinic (i.e., care for a condition that is not such that the absence ab- sence of immediate medical attention could reasonably rea- sonably be expected to result in placing your health in serious jeopardy, serious impairment to bodily functions, or serious dysfunction of any bodily organ or part), you must first call your Pri- xxxx Care Per- xxxxx Physician. However, you may go di- rectly directly to an urgent care clinic when your assigned Medical Group/IPA has provided you with instruc- tions instructions for obtaining care from an urgent care clinic in your Primary Care Personal Physician Service Area.