Episode of care definition

Episode of care means a period of continuous hospital treatment, including readmission within a seven
Episode of care means a specific medical problem, condition, or specific illness being managed including tests, procedures and rehabilitation initially requested by health care practitioner, to be performed at, the site of service, excluding out of network care: Provided, That any additional testing or procedures related or unrelated to the specific medical problem, condition, or specific illness being managed may require a separate prior authorization.
Episode of care means services provided to a patient by a health provider that:

Examples of Episode of care in a sentence

  • In any event, if an Episode of Care extends thirty (30) days beyond the date the Participant was originally admitted to the facility, the Episode of Care will be considered terminated.

  • If at any time during an Episode of Care, a Provider determines that any Medically Necessary Service must be performed on an urgent or emergency basis to preserve the life or health of the Participant, Sponsor will be responsible for payment of the Provider’s charges for any such Medically Necessary Service as part of the Episode of Care.

  • If applicable, a Provider will establish treatment protocols for an Episode of Care and, if needed, the Provider will modify such protocols for a Participant.

  • Following Provider’s initial review of Participant’s medical records and information, and subject to a physical examination and medical assessment of Participant, as determined necessary by a Provider, a Provider will confirm to EDH whether or not, in Provider’s independent medical opinion, Participant is a suitable candidate for Covered Services during an Episode of Care at a Provider’s location, and Provider will advise EDH of the Diagnosis Case Code related to such Episode of Care.

  • EDH’s obligations under this Agreement extend only through the end of an Episode of Care.


More Definitions of Episode of care

Episode of care means (i) all services rendered by a SurgeryPlus network provider and provider’s professional and medical staff, as applicable and (ii) all hospital- or facility-related expenses under the diagnosis case code. The Episode of Care begins on the day the patient first receives services from the provider related to the diagnosis case code and ends when the patient is discharged from the hospital or facility to return or travel home. Services and expenses under the diagnosis case code commonly included in the Episode of Care are equipment used while in hospital or facility, in-hospital or in-facility medications or biologics and supplies, implants, labs, in-hospital meals, hospital confinement days, pre- and post in-hospital or in-facility nursing care, in-hospital physical therapy and follow-up consultations, and any other medically necessary care related to the diagnosis case code rendered prior to discharge. An Episode of Care shall not include
Episode of care means a specific medical problem, condition, or specific illness being
Episode of care means medical services, nursing services, or health-related services provided by a health care institution to a patient for a specific period of time, ending in discharge or the completion of the patient’s treatment plan, whichever is later.
Episode of care means medical services, nursing services, or health-related services provided by a hospital to a patient for a specific period of time, ending with a discharge.
Episode of care means the medical care ordered to be provided
Episode of care means care that begins at treatment admission and ends at discharge. An admission has occurred if, and only if, the Client begins treatment. Events such as initial screening, Referral, and wait-listing for treatment are considered to take place before the admission to treatment and should not be considered as admission.
Episode of care means a period of consecutive days— ‘‘(i) beginning with the first day on which a veteran