Emergency Case definition

Emergency Case means medical services are necessary to treat a condition or illness that, without immediate medical attention, would either (i) seriously jeopardize the life or health of the Member or the Member’s ability to regain maximum function, or (ii) cause the Member to be in danger to self or others.

Emergency Case means: (a) an adverse decision is rendered for a dental service or procedure that is proposed but has not been delivered; and (b) the dental service or procedure is necessary to treat a condition or illness that, without immediate medical attention, would seriously jeopardize Your life or health or Your to regain maximum function, or cause You to be in danger to self or others.

Emergency Case means an urgent case; "facility" means health care facility;

Examples of Emergency Case in a sentence

• An expedited review of an Emergency Case may be initiated by calling 1-404-364-4862 or TTY/TDD 1-800-255-0056.Once an expedited review is initiated, a clinical review will determine whether you have a medical condition that meets the definition of an Emergency Case.

• Note: In cases in which a complaint is filed with the Commissioner, you or your Authorized Representative must authorize the release of medical records to the Commissioner to assist with reaching a decision in the complaint.Expedited Grievances for Emergency CasesYou or your Authorized Representative may seek an expedited review in the event of an Emergency Case as that term is defined for this section.

• An expedited review of an Emergency Case may be initiated by calling 1-800-777-7902.Once an expedited review is initiated, a clinical review will determine whether you have a medical condition that meets the definition of an Emergency Case.

• If you have an Emergency Case, then a request for concurrent review will be handled like any other pre-service request for review when an Emergency Case is involved, except that our decision will be made within one (1) working day.If Health Plan authorizes an extended stay or additional health care Services under the concurrent review, the Health Plan will:1.

• Expedited Grievances for Emergency CasesYou or your Authorized Representative may seek an expedited review in the event of an Emergency Case as that term is defined for this section.

More Definitions of Emergency Case

Emergency Case. A case in which an Adverse Decision was rendered pertaining to Health Care Services which have yet to be delivered and such Health Care Services are necessary to treat a condition or illness that, without immediate medical attention would:

Emergency Case means a situation in which there is an imminent threat to the life, physical integrity or safety of a person, or to a critical infrastructure, as defined in Article 2, point (a), of Directive 2008/114/EC, where the disruption to or destruction of such critical infrastructure would result in an imminent threat to the life, physical integrity or safety of a person, including through serious harm to the provision of basic supplies to the population or to the exercise of the core functions of the State;

Emergency Case. A case in which an Adverse Decision was rendered pertaining to Health Care Services which have yet to be delivered and such Health Care Services are necessary to treat a condition or illness that, without medical attention would: (a) seriously jeopardize the life or health of the Member or the Member’s ability to regain maximum function; or (b) cause the Member to be in danger to self or others. Grievance: A protest filed by a Member with Health Plan through our internal grievance process regarding an Adverse Decision concerning the Member. A Grievance does not include a verbal request for reconsideration of a Utilization Review determination.

Emergency Case. Emergency medical treatment required based on the beneficiary’s medical case, as a result of accident, occasional event or emergency health case requiring rapid medical intervention, as per the following levels (1. resuscitation. 2. Emergency.) of the levels of urgent medical care, as outlined in Private Health Institutions Law and Its Executive Regulations, approved by the Ministry of Health, set to screen emergencies. الحالة الطارئة: العلاج الطبي الطارئ الذي تقتضيه الحالة الطبية للمستفيد إثر وقوع حدث، أو عارض أو حالة صحية طارئة تستدعي التدخل الطبي السريع حسب المستويات التالية (1- الإنعاش. 2- الطوارئ.) من مستويات الرعاية الطبية العاجلة كما هو موضح بنظام المؤسسات الصحية الخاصة ولائحته التنفيذية المعتمدة من وزارة الصحة والذي يحدد فرز الحالات الطارئة. Health: State of complete physical, mental and social safety, not merely the absence of disease or infirmity. الصحة: حالة من اكتمال السلامة بدنياً وعقلياً واجتماعياً، لا مجرد انعدام المرض أو العجز.

Emergency Case. Emergency medical treatment required based on the beneficiary’s medical case, as a result of accident, occasional event or emergency health case requiring rapid medical intervention, as per the following ةلاحلا هيضتقت يذلا ئراطلا يبطلا جلاعلا :ةئراطلا ةلاحلا 1.20 ةلاح وأ ضراع وأ ،ثدح عوقو رثإ ديفتسملل ةيبطلا بسح عيرسلا يبطلا لخدتلا يعدتست ةئراط ةيحص تايوتسم نم ).ئراوطلا -2 .شاعنلإا -1( ةيلاتلا تايوتسلما levels (1. resuscitation. 2. Emergency.) of the levels of urgent medical care, as outlined in Private Health Institutions Law and Its Executive Regulations, approved by the Ministry of Health, set to screen emergencies. تاسسؤلما ماظنب حضوم وه امك ةلجاعلا ةيبطلا ةياعرلا ةرازو نم ةدمتعلما ةيذيفنتلا هتحئلاو ةصاخلا ةيحصلا .ةئراطلا تلااحلا زرف ددحي يذلاو ةحصلا

Emergency Case means a case involving an adverse decision for which an expedited review is requested. “Filing date” means the earlier of:

Emergency Case means a case involving an adverse decision for which an expedited review is required if the: (a) adverse decision is rendered for health care services that are proposed but have not been delivered; and (b) services are necessary to treat a condition or illness that, without immediate medical attention, would: (1) seriously jeopardize the life or health of the member or the member’s ability to regain maximum function; (2) cause the member to be in danger to self or others; or (3) cause the member to continue using intoxicating substances in an imminently dangerous manner.