Examples of Hospital in a sentence
Participation in the program is voluntary - no penalty or benefit reduction is imposed if you do not wish to participate in Case Management.• Following an initial assessment, the Case Manager works with you, your family and Physician to determine the needs of the patient and to identify what alternate treatment programs are available (for example, in-home medical care in lieu of an extended Hospital convalescence).
The goal of Case Management is to ensure that patients receive appropriate care in the most effective setting possible whether at home, as an outpatient, or an inpatient in a Hospital or specialized facility.Should the need for Case Management arise, a Case Management professional will work closely with the patient, his or her family and the attending Physician to determine appropriate treatment options which will best meet the patient's needs and keep costs manageable.
If a Member is admitted as an inpatient at a Hospital at which a Hospitalist Program exists, the Member is subject to the Hospitalist Program.
If the Member refuses care from the Hospitalist Program physician and instead accepts inpatient Hospital care from his own primary care physician (not including OB/GYN and pediatric Physicians) or any other non-specialist Hospital based Physician outside of the Hospitalist Program, the Plan will pay nothing for such care and the Member will be solely responsible for all amounts billed by such primary care physician.
DME includes, but is not limited to: • Braces;• Canes;• Crutches;• Intermittent positive pressure breathing machine;• Hospital beds;• Standard outpatient oxygen delivery systems;• Traction equipment;• Walkers;• Wheelchairs; or• Any other items that are determined to be Medically Necessary by the CO-OP’s Care Management Program Replacements, repairs and adjustments to DME are limited to normal wear and tear or because of significant change in the Member’s physical condition.