High Tech Imaging definition

High Tech Imaging. Imaging services which include, but are not limited to MRIs, MRAs, CT scans, PET scans and nuclear cardiology. Home Health Care – Health services rendered in the individual’s place of residence by an organization licensed as a Home Health Care agency by the appropriate state agency and approved by Us. These organizations are primarily engaged in providing to individuals, at the written direction of a licensed Physician, in the individual’s place of residence, skilled nursing services by or under supervision of a Registered Nurse (R.N.) licensed to practice in the state. Hospice Care – Provision of an integrated set of services and supplies designed to provide palliative and supportive care to meet the special needs of Members and their families during the final stages of terminal illness. Full scope health services are centrally coordinated through an interdisciplinary team directed by a Physician and provided by or through a Hospice Care agency approved by the Company. Hospital – An institution that is licensed by the appropriate state agency as a general medical surgical Hospital. The term Hospital may also include an institution that primarily provides psychiatric, chemical dependency, rehabilitation, skilled nursing, long-term, intermediate or other specialty care. Implantable Medical Devices – A medical device that is surgically implanted in the body, is not reusable, and can be removed. Independent Review Organization (IRO) – An independent review organization, not affiliated with the Company, that conducts external reviews of final Adverse Benefit Determinations. The decision of the IRO is binding on both the insured and the Company.
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Examples of High Tech Imaging in a sentence

  • Medically Necessary High Tech Imaging, including but not limited to MRIs, MRAs, CT scans, PET scans, and nuclear cardiology are covered.

  • High Tech Imaging services such as an MRI, MRA, CT scan, PET scan, nuclear cardiology, colonoscopy, flexible sigmoidoscopy and endoscopy are not covered under this Preventive or Wellness Care Benefit.

  • These High Tech Imaging services may be covered under standard contract Benefits when the tests are Medically Necessary.

  • These High Tech Imaging services are covered under standard contract Benefits when the tests are Medically Necessary.

  • Copayments shall be the following amounts: Physician office visits $20 Three tiered retail prescriptions $10/$25/$45 Three tiered mail order prescriptions $20/$50/$90 Emergency room (waived if admitted) $100 Deductible $0 Specialist office visits $20 Hospital admission $0 Ambulatory / Outpatient Surgery $0 High Tech Imaging (MRI, CT, PET) $0 There shall be no plan design changes made for the January 1, 2017 through and including December 31, 2019.

  • When a Network Provider performs services that the Network Provider is not contracted with Us to perform (such as certain High Tech Imaging Services or radiology procedures), claims for those services will be adjudicated at the Non-Network Benefit level.

  • When a Network Provider performs services that the Network Provider is not contracted with Us to perform (such as certain High Tech Imaging, diagnostic or radiology procedures), claims for those services will be adjudicated at the Non-Network Benefit level.