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

Emergency Case means a situation where significant financial loss may occur or may result to serious disruption to business;

Emergency Case means a case involving an adverse decision for which an expedited review is required if:

Emergency Case means a case involving an adverse decision for which an expedited review is required under Maryland law.

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 means an acute illness that needs immediate or life-saving treatment at the Hospital requiring, in the opinion of the Admitting Medical Officer, admission other than in accordance with routine procedures.