Ambulance Services Ground Ambulance Sample Clauses

Ambulance Services Ground Ambulance. In accordance with Rhode Island General Law § 27-20-55, ground ambulance services are covered up to the benefit limits listed in the Summary of Medical Benefits. Local professional or municipal ground ambulance services are covered when it is medically necessary to use these services, rather than any other form of transportation, to these places: • to the closest available hospital for an inpatient admission; • from a hospital to home, a skilled nursing facility, or a rehabilitation facility after being discharged as an inpatient; • to the closest available hospital emergency room immediately in an emergency; • to and from a hospital for medically necessary services not available in the facility where you are an inpatient; or • from a physician’s office to a skilled nursing facility. Our allowance for the ground ambulance includes the services rendered by an emergency medical technician or paramedic, drugs, supplies and cardiac monitoring.
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Ambulance Services Ground Ambulance. In accordance with Rhode Island General Law § 27-20-55, ground ambulance services are covered as listed in the Summary of Medical Benefits. Local professional or municipal ground ambulance services are covered when it is medically necessary to use these services, rather than any other form of transportation, included, but not limited, to the following:  from a hospital to home, a skilled nursing facility, or a rehabilitation facility after being discharged as an inpatient;  to the closest available hospital emergency room in an emergency situation: or;  from a physician’s office to an emergency room. Our allowance for the ground ambulance includes the services rendered by an emergency medical technician or paramedic, drugs, supplies and cardiac monitoring. Air and Water Ambulance Medically necessary air and water ambulance services are covered as shown in the Summary of Medical Benefits. When you receive services from a network provider, you are responsible to pay the deductible and copayment (if any), and the difference between our allowance and the maximum benefit limit. You are responsible to pay up to the total charge when a non- network provider renders air or water ambulance services. Air ambulance service means transportation by a helicopter or fixed wing plane. The aircraft must be a certified ambulance. The crew, maintenance support crew and aircraft must meet the certification requirements and hold a certificate for air ambulance operators under Part 135 of the Federal Aviation Administration (FAA) regulations. Water ambulance means transportation by a boat. The boat must be specially designed and equipped for transporting the sick or injured. It must also have such other safety and lifesaving equipment per state or local regulation. Use of an air or water ambulance is medically necessary when the time needed to move a patient by land, or the instability of transportation by land, may threaten a patient’s condition or survival. It is also medically necessary if the proper equipment needed to treat the patient is not available on a ground ambulance. The patient must be transported for treatment to the nearest facility that can provide a level of care for the patient’s illness. It must have available the type of physician or physician specialist needed to treat the patient’s condition. We will only cover air and water ambulance services originating and ending in the United States and its territories. Our allowance for the air or water ambulance ...
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Ambulance Services Ground Ambulance. Local professional or municipal ground ambulance services are covered up to the benefit limits and level of coverage listed in the Summary of Benefits when it is medically necessary to use these services, rather than any other form of transportation, to the following destinations:
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Ambulance Services Ground Ambulance. In accordance with Rhode Island General Law § 27-20-55, ground ambulance services are covered as listed in the Summary of Medical Benefits. Local professional or municipal ground ambulance services are covered when it is medically necessary to use these services, rather than any other form of transportation, included, but not limited to, the following: • from a hospital to home, a skilled nursing facility, or a rehabilitation facility after being discharged as an inpatient; • to the closest available hospital emergency room in an emergency situation; or • from a physician’s office to an emergency room. Our allowance for the ground ambulance includes the services rendered by an emergency medical technician or paramedic, drugs, supplies and cardiac monitoring. Air and Water Ambulance Medically necessary air and water ambulance services are covered as listed in the Summary of Medical Benefits. Medically necessary air and water ambulance services are covered up to the maximum benefit limit as shown in the Summary of Medical Benefits. When you receive services from a network provider, you are responsible to pay the deductible and copayment (if any), and the difference between our allowance and the maximum benefit limit. You are responsible to pay up to the total charge when a non-network provider renders air or water ambulance services. Air ambulance service means transportation by a helicopter or fixed wing plane. The aircraft must be a certified ambulance. The crew, maintenance support crew, and aircraft must meet the certification requirements and hold a certificate for air ambulance operators under Part 135 of the Federal Aviation Administration (FAA) regulations. Water ambulance means transportation by a boat. The boat must be specially designed and equipped for transporting the sick or injured. It must also have such other safety and lifesaving equipment per state or local regulation. Use of an air or water ambulance is medically necessary when the time needed to move a patient by land, or the instability of transportation by land, may threaten a patient’s condition or survival. It is also medically necessary if the proper equipment needed to treat the patient is not available on a ground ambulance. The patient must be transported for treatment to the nearest facility that can provide a level of care for the patient’s illness. It must have available the type of physician or physician specialist needed to treat the patient’s condition. We will only cover a...
Sample 1

Related to Ambulance Services Ground Ambulance

  • Ambulance Services Ground Ambulance This plan covers local professional or municipal ground ambulance services when it is medically necessary to use these services, rather than any other form of transportation as required under R.I. General Law § 27-20-55. Examples include but are not limited to the following: • from a hospital to a home, a skilled nursing facility, or a rehabilitation facility after being discharged as an inpatient; • to the closest available hospital emergency room in an emergency situation; or • from a physician’s office to an emergency room. Our allowance for ground ambulance includes the services rendered by an emergency medical technician or paramedic, as well as any drugs, supplies and cardiac monitoring provided. Air and Water Ambulance This plan covers air and water ambulance services when: • the time needed to move a patient by land, or the instability of transportation by land, may threaten a patient’s condition or survival; or • if the proper equipment needed to treat the patient is not available from a ground ambulance. The patient must be transported to the nearest facility where the required services can be performed and the type of physician needed to treat the patient’s condition is available. Our allowance for the air or water ambulance includes the services rendered by an emergency medical technician or paramedic, as well as any drugs, supplies and cardiac monitoring provided.

  • Hospice Services Services are available for a Member whose Attending Physician has determined the Member's illness will result in a remaining life span of six months or less.

  • Ambulance The deductible and coinsurance for services not subject to copays applies.

  • Surgery Services This plan covers surgery services to treat a disease or injury when: • the operation is not experimental or investigational, or cosmetic in nature; • the operation is being performed at the appropriate place of service; and • the physician is licensed to perform the surgery. Preauthorization may be required for certain surgical services. Reconstructive Surgery for a Functional Deformity or Impairment This plan covers reconstructive surgery and procedures when the services are performed to relieve pain, or to correct or improve bodily function that is impaired as a result of: • a birth defect; • an accidental injury; • a disease; or • a previous covered surgical procedure. Functional indications for surgical correction do not include psychological, psychiatric or emotional reasons. This plan covers the procedures listed below to treat functional impairments. • abdominal wall surgery including panniculectomy (other than an abdominoplasty); • blepharoplasty and ptosis repair; • gastric bypass or gastric banding; • nasal reconstruction and septorhinoplasty; • orthognathic surgery including mandibular and maxillary osteotomy; • reduction mammoplasty; • removal of breast implants; • removal or treatment of proliferative vascular lesions and hemangiomas; • treatment of varicose veins; or • gynecomastia. Preauthorization may be required for these services.

  • Ambulance Escort Where a nurse is assigned to provide patient care for a patient in transit, the following provisions shall apply:

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  • Community Mental Health Center Services Assertive Community Treatment Staffing Full Time Equivalents Community Mental Health Center March 2021 December 2020 Nurse Masters Level Clinician/or Functional Support Worker Peer Specialist Total (Excluding Psychiatry) Psychiatrist/Nurse Practitioner Total (Excluding Psychiatry) Psychiatrist/Nurse Practitioner 01 Northern Human Services - Wolfeboro 1.00 0.00 0.00 0.57 6.81 0.27 8.27 0.25 01 Northern Human Services - Berlin 0.34 0.31 0.00 0.00 3.94 0.14 4.17 0.14 01 Northern Human Services - Littleton 0.00 0.14 0.00 0.00 3.28 0.29 3.31 0.29 02 West Central Behavioral Health 0.60 1.00 0.00 0.00 5.40 0.30 5.90 0.30 03 Lakes Region Mental Health Center 1.00 1.00 0.00 1.00 5.00 0.40 7.00 0.38 04 Riverbend Community Mental Health Center 0.50 1.00 6.90 1.00 10.40 0.50 10.50 0.50 05 Monadnock Family Services 1.91 2.53 0.00 1.12 11.17 0.66 10.32 0.62 06 Greater Nashua Mental Health 1 1.00 1.00 3.00 1.00 7.65 0.15 8.50 0.15 06 Greater Nashua Mental Health 2 1.00 1.00 4.00 1.00 8.65 0.15 8.50 0.15 07 Mental Health Center of Greater Manchester-CTT 1.33 10.64 2.00 0.00 19.95 1.17 21.61 1.21 07 Mental Health Center of Greater Manchester-MCST 1.33 9.31 3.33 1.33 19.95 1.17 25.27 1.21 08 Seacoast Mental Health Center 1.00 1.10 5.00 1.00 10.10 0.60 10.10 0.60 09 Community Partners 0.50 0.00 3.40 0.88 7.28 0.70 7.41 0.70 10 Center for Life Management 1.00 0.00 2.28 1.00 6.71 0.46 6.57 0.46 Total 12.51 29.03 29.91 9.33 126.29 6.96 137.43 6.96 2b. Community Mental Health Center Services: Assertive Community Treatment Staffing Competencies Community Mental Health Center Substance Use Disorder Treatment Housing Assistance Supported Employment March 2021 December 2020 March 2021 December 2020 March 2021 December 2020 01 Northern Human Services - Wolfeboro 1.27 1.27 5.81 6.30 0.00 0.40 01 Northern Human Services - Berlin 0.74 0.74 3.29 3.29 0.00 0.23 01 Northern Human Services - Littleton 1.43 1.29 2.14 2.14 1.00 1.00 02 West Central Behavioral Health 0.20 0.20 4.00 0.40 0.60 0.60 03 Lakes Region Mental Health Center 1.00 3.00 5.00 7.00 2.00 2.00 04 Riverbend Community Mental Health Center 0.50 0.50 9.40 9.50 0.50 0.50 05 Monadnock Family Services 1.69 1.62 4.56 4.48 0.95 1.18 06 Greater Nashua Mental Health 1 6.15 7.15 5.50 6.50 1.50 1.50 06 Greater Nashua Mental Health 2 5.15 5.15 6.50 6.50 0.50 0.50 07 Mental Health Center of Greater Manchester-CCT 14.47 15.84 13.96 15.62 2.66 2.66 07 Mental Health Center of Greater Manchester-MCST 6.49 7.86 15.29 19.28 1.33 2.66 08 Seacoast Mental Health Center 2.00 2.00 5.00 5.00 1.00 1.00 09 Community Partners 1.20 1.20 4.50 4.50 1.00 1.00 10 Center for Life Management 2.14 2.14 5.42 5.28 0.29 0.29 Total 44.43 49.96 90.37 99.39 13.33 15.52 Revisions to Prior Period: None. Data Source: Bureau of Mental Health CMHC ACT Staffing Census Based on CMHC self-report. Notes: Data compiled 04/26/2021. For 2b: the Staff Competency values reflect the sum of FTEs trained to provide each service type. These numbers are not a reflection of the services delivered, but rather the quantity of staff available to provide each service. If staff are trained to provide multiple service types, their entire FTE value is credited to each service type.

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