Urgent Care Services definition

Urgent Care Services means health services that are medically appropriate and immediately required to prevent serious deterioration of a client’s health that are a result of unforeseen illness or injury.
Urgent Care Services means those health care services that are appropriately provided for an unforeseen condition of a kind that usually requires medical attention without delay but that does not pose a threat to the life, limb, or permanent health of the injured or ill person, and may include such health care services provided out of the health insuring corporation's approved service area pursuant to indemnity payments or service agreements.
Urgent Care Services means a medical care or other service for a condition where application of the timeframe for making routine or non-life threatening care determinations is either of the following:

Examples of Urgent Care Services in a sentence

  • Urgent care services" means those health care services that are appropriately provided for an unforeseen condition of a kind that usually requires medical attention without delay but that does not pose a threat to the life, limb, or permanent health of the injured or ill person, and may include such health care services provided out of the health insuring corporation's approved service area pursuant to indemnity payments or service agreements.

  • See Prevention and Early Detection Services for preventive colorectal services.) 0% - After deductible 20% - After deductible Lyme disease diagnosis and treatment 0% - After deductible 20% - After deductible Urgent Care Urgent care services $100 The level of coverage is the same as network provider.


More Definitions of Urgent Care Services

Urgent Care Services means initial care for a sudden and unforeseen illness or injury when the member is TEMPORARILY away from the Hawaii service area, which is required to prevent serious deterioration of the member's health and which cannot be delayed until the member is medically able to safely return to the Hawaii service area or travel to a Kaiser Permanente facility in another Health Plan Region. Continuing or follow-up treatment at a non-Kaiser Permanente facility is not covered.
Urgent Care Services are those Covered Services (other than Emergency Services) which are Medically Necessary to prevent serious deterioration of a Member’s health, alleviate severe pain, or treat an illness or injury with respect to which treatment can not reasonably be delayed. For Blue Shield 65 Plus Members, Urgent Care Services, at a minimum, include all services which are defined by Center for Medicare and Medicaid Services (CMS) as “Urgently Needed Services”.
Urgent Care Services means health care services, other than Emergency Care, which are typically provided in settings such as a physician or provider’s office or urgent care center, as a result of an acute injury or illness that is severe or painful enough to lead a prudent layperson, possessing an average knowledge of medicine and health, to believe that his or her condition, illness or injury is of such a nature that failure to obtain treatment within a reasonable period of time would result in serious deterioration of the condition of his or her health.
Urgent Care Services means health care items
Urgent Care Services means services intended to provide urgently needed care in a timely manner when the Member’s PCP has determined that he or she requires these services, or the Member is Out-of-Area and requires Urgent Care Services. Urgent Care Services means those services performed, inside or outside Plan's Service Area, that are medically required within a short timeframe, usually within 24 hours, in order to prevent a serious deterioration of a Member's health due to an illness, injury, or complication of an existing condition, including pregnancy, for which treatment cannot be delayed. Urgently needed services include maternity services necessary to prevent serious deterioration of the health of the Member or the Member’s fetus, based on the Member’s reasonable belief that she has a pregnancy-related condition for which treatment cannot be delayed until the Member returns to Plan's Service Area. Urgent Care Services are covered worldwide in accordance with the following provisions:
Urgent Care Services means any medical care or treatment with respect to which the application of the time periods for making non-Urgent Care Services determinations (A) could seriously jeopardize your life or health or your ability to regain maximum function or (B) in the opinion of the attending Provider, would subject you to severe pain that cannot be adequately managed without the care or treatment that is the subject of the certification. A listing of the benefits requiring Pre-Certification can be found on our website: XxxxxxxXxxxx.xxx or by calling Customer Service at 1-800-811-4793. The Pre-Certification list is subject to change.
Urgent Care Services in this section means any medical care or treatment to which the application of the time periods for making non-Urgent Care Services determinations (A) could seriously jeopardize Your life or health or Your ability to regain maximum function or (B) in the opinion of the attending Provider, would subject You to severe pain that cannot be adequately managed without the care or treatment that is the subject of the certification. A listing of the benefits requiring Prior Authorization can be found on Our website: XxxxxxxXxxxx.xxx or by calling Client Services at (000) 000-0000. The Prior Authorization list is subject to change. BENEFITS‌ All Covered Services must be Medically Necessary whether provided through In-Network Providers or Out-of-Network Providers. Some Covered Services may require Prior Authorization, please call Client Services at (000) 000-0000 or visit XxxxxxxXxxxx.xxx to confirm whether a specific benefit requires Prior Authorization. ALLERGY CONDITIONS Standard Medically Necessary testing and treatment for allergy conditions are covered (see “What is Not Coveredfor non-standard tests that are considered a Non-Covered Service). AMBULANCE SERVICE Emergency ambulance services are a Covered benefit when they are considered Medically Necessary and at least one of the following criteria are met: • You are transported by a state licensed vehicle that is designed, equipped, and used only to transport the sick and injured and staffed by Emergency Medical Technicians (EMT), paramedics, or other certified professionals. This includes ground, fixed wing, rotary wing or water transportation. • You are taken: ° From Your home, scene of an accident or medical emergency to a Hospital; ° Between Hospitals, including when We require You to move from an Out-of-Network Hospital to and In-Network Hospital; or ° Between a Hospital, Skilled Nursing Facility (ground transport only) or approved facility. You must be taken to the nearest facility that can give care for Your condition. During an appeal review, We may approve benefits for transportation to a facility that is not the nearest facility. Benefits may include Medically Necessary treatment of sickness or injury by medical professionals during an ambulance service, even if You are not taken to a facility. Out-of-Network Providers may bill You for charges that exceed the MAC for services that may be covered but are non-emergent. GROUND AMBULANCE Services are subject to Medical Necessity review by Alliant. All ...