AMBULATORY SURGERY. Ambulatory or out-patient surgical procedures performed in a hospital, clinic, or doctor’s office are covered according to the Table of benefits. These surgeries allow the patient to go home the same day that they have the surgi- cal procedure.
AMBULATORY SURGERY. Ambulatory or out-patient surgical procedures per- formed in a hospital, clinic, or doctor’s office are covered according to the Table of benefits. These surgeries allow the patient to go home the same day that they have the surgical procedure.
AMBULATORY SURGERY. Services include preoperative examinations, operating and recovery room services, and all required drugs and medicine.
AMBULATORY SURGERY. 17 1. Ambulatory Surgery nurses required to be on on-call may arrange for 18 qualified nurse volunteers from other nursing service department to take 19 such on-call; provided that this would not lead to total compensation for 20 the involved nurses greater than that which would have been payable if 21 such arrangement had not been made, and provided further that the 22 specific arrangement has been approved by Hospital.
AMBULATORY SURGERY. The Contractor shall provide surgical services for either emergency or scheduled surgeries when provided in an ambulatory or outpatient setting such as a freestanding surgical center or a hospital-based outpatient surgical setting. American Indian Health Program (AIHP): The AHCCCS Division of Fee For Service (DFSM) will reimburse claims for acute care services that are medically necessary, and are provided to Title XIX members enrolled with the Contractor in an IHS or a tribal 638 facility, eligible for 100% Federal reimbursement when the member is eligible to receive services at the HIS or tribally operated 638 program. Encounters for Title XIX services billed by an IHS or tribal facilities will not be accepted by AHCCCS or considered in capitation rate development. The Contractor is responsible for reimbursement to IHS or tribal facilities for services provided to Title XXI American Indian members enrolled with the Contractor. The Contractor may choose to subcontract with an IHS or 638 tribal facility as part of its provider network for the delivery of Title XXI covered services. Expenses incurred by the Contractor for Title XXI services billed by an IHS or a 638 tribal facility shall be encountered and considered in capitation rate development.
AMBULATORY SURGERY. Centers (ASCs) must maintain the following current licenses, permits, and registrations (where required):
AMBULATORY SURGERY. A cost management program referred to in the Network Agreement. For present purposes, this shall mean any requirement contained in a Policy or the Provider Manual that the Medical Necessity of a particular type of ambulatory surgery service be precertified or preauthorized in advance of the provision of service. The term shall also include any program of retrospective review of the Medical Necessity of such services.
AMBULATORY SURGERY. The Contractor shall provide surgical services for either emergency or scheduled surgeries when provided in an ambulatory or outpatient setting, such as a freestanding surgical center or a hospital- based outpatient surgical setting.
AMBULATORY SURGERY. Center development; (3) HCAP/ER benefit-review; (4) The ongoing review of the Managed Physical Medicine Program; (5) Review of the appropriateness
AMBULATORY SURGERY. Center development; (3) HCAP/ER benefit-review; (4) The ongoing review of the Managed Physical Medicine Program; (5) Review of the appropriateness of providing a benefit for autologous blood donations; (6) Review the appropriateness of additional chronic copayment waivers; (7) Work with the dental carrier to increase access to participating dental specialists such as orthodontists; (8) Explore the addition of a Lyme Vaccine to the list of injectable adult immunizations should one become available; (9) Work with the State to monitor and oversee a voluntary disease management program under the medical component of the Empire Plan; Work with the State to develop and implement 2 to 3 additional disease management programs; (10) The ongoing review of a Medical Flexible Spending Account; (11) Work with the State to monitor and oversee the voluntary "Centers of Excellence" program for organ and tissue transplants within the hospital component of the Empire Plan; (12) Work with the State and medical carrier to develop an enhanced network of urgent care facilities; (13) Work with the State to implement a direct debit vehicle to be utilized under the Medical Flexible Spending Account.
