Medically appropriate treatment definition

Medically appropriate treatment means the services and supports necessary to diagnose, stabilize, care for and treat a behavioral health condition.¶
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Medically appropriate treatment means the services and supports necessary to diagnose, stabilize,
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Examples of Medically appropriate treatment in a sentence

  • The general purpose of the Preauthorization program is to facilitate the receipt by Members of:  Medically appropriate treatment to meet individual needs;  Care provided by Participating Providers delivered in an efficient and effective manner; and  Maximum available benefits, resources, and coverage.

  • The general purpose of the preauthorization program is to facilitate the receipt by Members of: Medically appropriate treatment to meet individual needs; Care provided by participating providers delivered in an efficient and effective manner; and Maximum available benefits, resources, and coverage.Participating providers are responsible for obtaining required preauthorizations.However, if a non-participating provider is used, the Member is responsible for obtaining the required preauthorization.

  • The general purpose of the Preauthorization program is to facilitate the receipt by Members of: Medically appropriate treatment to meet individual needs; Care provided by participating providers delivered in an efficient and effective manner; and Maximum available benefits, resources, and coverage.Participating Providers are responsible for obtaining required Preauthorizations.However, if a Nonparticipating Provider is used, the Member is responsible for obtaining the required Preauthorization.

  • The general purpose of the Preauthorization program is to facilitate the receipt by Members of: • Medically appropriate treatment to meet individual needs; • Care provided by Participating Providers delivered in an efficient and effective manner; and • Maximum available benefits, resources, and coverage.

  • The general purpose of the preauthorization program is to facilitate the receipt by members of: Medically appropriate treatment to meet individual needs; Care provided by participating providers delivered in an efficient and effective manner; and Maximum available benefits, resources, and coverage.Participating providers are responsible for obtaining required preauthorizations.However, if a nonparticipating provider is used, the member is responsible for obtaining the required preauthorization.

  • The general purpose of the preauthorization program is to facilitate the receipt by members of: Medically appropriate treatment to meet individual needs; Care provided by participating providers delivered in an efficient and effective manner; and Maximum available benefits, resources, and coverage.Participating providers are responsible for obtaining required preauthorizations.However, if a non-participating provider is used, the member is responsible for obtaining the required preauthorization.

  • The general purpose of the preauthorization program is to facilitate the receipt by members of:• Medically appropriate treatment to meet individual needs;• Care provided by participating providers delivered in an efficient and effective manner; and• Maximum available benefits, resources, and coverage.Participating providers are responsible for obtaining required preauthorizations.However, if a nonparticipating provider is used, the member is responsible for obtaining the required preauthorization.

  • Medically appropriate treatment and/or removal of keloids requires prior approval from the State in the case of a Medicaid recipient.

Related to Medically appropriate treatment

  • medically approved means certified by a medical practitioner;

  • Medically Necessary Treatment means any treatment, tests, medication, or stay in hospital or part of a stay in hospital which:

  • Outpatient treatment means mental health or substance abuse treatment services rendered to a

  • Assisted outpatient treatment or "AOT" means the categories of outpatient services ordered by the court under section 468 or 469a. Assisted outpatient treatment may include a case management plan and case management services to provide care coordination under the supervision of a psychiatrist and developed in accordance with person-centered planning under section 712. Assisted outpatient treatment may also include 1 or more of the following categories of services: medication; periodic blood tests or urinalysis to determine compliance with prescribed medications; individual or group therapy; day or partial day programming activities; vocational, educational, or self-help training or activities; assertive community treatment team services; alcohol or substance use disorder treatment and counseling and periodic tests for the presence of alcohol or illegal drugs for an individual with a history of alcohol abuse or substance use disorder; supervision of living arrangements; and any other services within a local or unified services plan developed under this act that are prescribed to treat the individual's mental illness and to assist the individual in living and functioning in the community or to attempt to prevent a relapse or deterioration that may reasonably be predicted to result in suicide, the need for hospitalization, or serious violent behavior. The medical review and direction included in an assisted outpatient treatment plan shall be provided under the supervision of a psychiatrist.

  • Medically necessary care means care that is (1) appropriate and consistent with and essential for the prevention, diagnosis, or treatment of a Patient’s condition; (2) the most appropriate supply or level of service for the Patient’s condition that can be provided safely; (3) not provided primarily

  • Inpatient treatment means twenty-four-hour-per-day mental

  • Medically accurate means verified or supported by research conducted in compliance with scientific methods and published in peer-reviewed journals, where appropriate, and recognized as accurate and objective by professional organizations and agencies with expertise in the relevant field, such as the federal Centers for Disease Control and Prevention, the American Public Health Association, the American Academy of Pediatrics, and the American College of Obstetricians and Gynecologists.

  • Developmentally appropriate means suitable to the chronological age range and developmental characteristics of a specific group of children.

  • Substance abuse treatment means outpatient or inpatient services or participation in Alcoholics Anonymous or a similar program.

  • Medical Treatment means examination and treatment by a Legally Qualified Physician for a condition which first manifested itself, worsened or became acute or had symptoms which would have prompted a reasonable person to seek diagnosis, care or treatment.

  • Medically Necessary means a service which is appropriate and consistent with the treatment of the condition in accordance with accepted standards of community practice.

  • Medically Necessary Services means those covered services that are, under the terms and conditions of the contract, determined through contractor utilization management to be:

  • Day Care Treatment means medical treatment, and/or surgical procedure which is:

  • Free appropriate public education means special education and related services that:

  • Outpatient means a person who is receiving care other than on an inpatient basis, such as: • in a provider’s office; • in an ambulatory surgical center or facility; • in an emergency room; or • in a clinic. .

  • Generally applicable environmental radiation standards means standards issued by the U.S. Environmental Protection Agency (EPA) under the authority of the Atomic Energy Act of 1954, as amended, that impose limits on radiation exposures or levels, or concentrations or quantities of radioactive material, in the general environment outside the boundaries of locations under the control of persons possessing or using radioactive material.

  • Unproven/ Experimental treatment means the treatment including drug experimental therapy which is not based on established medical practice in India.

  • Medical evaluation means the process of assessing an individual's health status that includes a medical history and a physical examination of an individual conducted by a licensed medical practitioner operating within the scope of his license.

  • Respiratory care practitioner means a person who is

  • Antipsychotic medications means that class of drugs

  • Psychotropic medication means medication the prescribed intent of which is to affect or alter thought processes, mood, or behavior including but not limited to anti-psychotic, antidepressant, anxiolytic (anti-anxiety), and behavior medications. The classification of a medication depends upon its stated, intended effect when prescribed.

  • Medically fragile means the condition of a child who requires the availability of twenty-four-hour skilled care from a health care professional or specially trained staff or volunteers in a group care setting. These conditions may be present all the time or frequently occurring. If the technology, support and services being received by the medically fragile children are interrupted or denied, the child may, without immediate health care intervention, experience death.

  • Peer-reviewed medical literature means a published scientific study in a journal or other publication in which original manuscripts have been published only after having been critically reviewed for scientific accuracy, validity and reliability by unbiased independent experts, and that has been determined by the international committee of medical journal editors to have met the uniform requirements for manuscripts submitted to biomedical journals. Peer-reviewed medical literature does not include publications or supplements to publications that are sponsored to a significant extent by a pharmaceutical manufacturing company or health carrier.

  • Licensed health care practitioner means a physician, as defined in Section 1861(r)(1) of the Social Security Act, a registered professional nurse, licensed social worker or other individual who meets requirements prescribed by the Secretary of the Treasury.

  • Diagnosis means the definition of the nature of the Client's disorder. When formulating the Diagnosis of Client, CONTRACTOR shall use the diagnostic codes and axes as specified in the most current edition of the DSM published by the American Psychiatric Association. DSM diagnoses will be recorded on all IRIS documents, as appropriate.

  • Uniformly Applicable in the context of a proposed Cross-Series Modification, means a Modification by which holders of Securities of all Series affected by that Modification are invited to exchange, convert or substitute their Securities on the same terms for (x) the same new instruments or other consideration or (y) new instruments or other consideration from an identical menu of instruments or other consideration. It is understood that a Modification will not be considered to be Uniformly Applicable if each exchanging, converting or substituting holder of Securities of any Series affected by that Modification is not offered the same amount of consideration per amount of principal, the same amount of consideration per amount of interest accrued but unpaid and the same amount of consideration per amount of past due interest, respectively, as that offered to each other exchanging, converting or substituting holder of Securities of any Series affected by that Modification (or, where a menu of instruments or other consideration is offered, each exchanging, converting or substituting holder of Securities of any Series affected by that Modification is not offered the same amount of consideration per amount of principal, the same amount of consideration per amount of interest accrued but unpaid and the same amount of consideration per amount of past due interest, respectively, as that offered to each other exchanging, converting or substituting holder of Securities of any Series affected by that Modification electing the same option under such menu of instruments).