Hospital Emergency Department Visits Sample Clauses

Hospital Emergency Department Visits. In the event that You require treatment for an Emergency Medical Condition, seek immediate care at the nearest Hospital emergency department or call 911. Emergency Department Care does not require Preauthorization. However, only Emergency Services for the treatment of an Emergency Medical Condition are covered in an emergency department. We do not cover follow-up care or routine care provided in a Hospital emergency department. You should contact Us to make sure You receive the appropriate follow-up care.
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Related to Hospital Emergency Department Visits

  • Medical Emergency A medical condition which manifests itself by acute symptoms of sufficient severity (including severe pain) such that a prudent layperson, who possesses an average knowledge of health and medicine, could reasonably expect the absence of immediate attention to result in 1) placing the health of the individual (or with respect to a pregnant woman, the health of the woman or her unborn child) in serious jeopardy; 2) serious impairment to bodily functions; or 3) serious dysfunction of any bodily organ or part. Examples of a medical emergency are severe pain, suspected heart attacks and fractures. Examples of a non- medical emergency are minor cuts and scrapes. Medically Necessary and Medical Necessity Services a physician, exercising prudent clinical judgment, would use with a patient to prevent, evaluate, diagnose or treat an illness or injury or its symptoms. These services must:  Agree with generally accepted standards of medical practice  Be clinically appropriate in type, frequency, extent, site and duration., They must also be considered effective for the patient’s illness, injury or disease  Not be mostly for the convenience of the patient, physician, or other healthcare provider. They do not cost more than another service or series of services that are at least as likely to produce equivalent therapeutic or diagnostic results for the diagnosis or treatment of that patient’s illness, injury or disease. For these purposes, “generally accepted standards of medical practice” means standards that are based on credible scientific evidence published in peer reviewed medical literature. This published evidence is recognized by the relevant medical community, physician specialty society recommendations and the views of physicians practicing in relevant clinical areas and any other relevant factors. Member Any person covered under this plan. Mental Condition A condition that is listed in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM). This does not include conditions and treatments for chemical dependency. Mental Health Services Medically necessary outpatient and inpatient services provided to treat mental conditions. State and federal law require that the copays and coinsurance for mental health services will be no more than the copays and coinsurance for medical and surgical services. Prescription drugs for mental conditions are covered under the same terms and conditions as other prescription drugs covered under this plan.

  • Medical Emergencies If you encounter a medical emergency that makes you unable to pay your bill for a period of time, or that requires your account remain active, even if it has already been suspended or disconnected, Viasat may payment or reconnection options available for you. You must contact Viasat immediately upon learning of such emergency to determine what options are available in your situation. If you reside in Maine or Pennsylvania, please contact us regarding the specific procedures to follow for relief.

  • National Emergency In cases of national emergency, the Contractor must maintain and support certain systems/ functions considered mission essential. In this event, the Government may require that certain essential personnel report for duty or, may provide support on an on-call or as-needed basis.

  • Emergency Childcare Employees may use vacation leave for childcare emergencies after the employee has exhausted all of their accrued compensatory time. Use of vacation leave and sick leave for emergency childcare is limited to a combined maximum of four (4) days per calendar year.

  • Medical Care and Emergency Leave An employee is entitled to a leave of absence without pay because of any of the following:

  • Non-Emergency Transportation Routine medical transportation to and from Medicaid-covered scheduled medical appointments is covered by the non-emergency medical transportation (NEMT) broker Medicaid program. This includes transportation via multi-passenger van services and common carriers such as public railways, buses, cabs, airlines, ambulance as appropriate, and private vehicle transportation by individuals. The NEMT broker must approve ambulance, multi-passenger van services, and transportation by common carriers. The MCO must inform enrollees of how to access non-emergency transportation as appropriate.

  • Emergency Closures A. The University’s inability to make a Room available to me for any reason beyond the University’s control including, but not limited to, natural disaster, fire, flood, earthquake, condemnation, pandemic, quarantine, utility malfunction, infestation, or other emergency or force majeure event shall not constitute a breach of this Agreement by the University. In such circumstances, the University shall have no liability to me in any way for injuries, reimbursement, damages, inconvenience, annoyance or compensation of any kind. The University may attempt to find, but cannot guarantee, an alternative space for me. If the unavailability of my Room or an alternative space persists for more than 72 hours, I may terminate this Agreement and Check out during said unavailability without penalty provided that I shall be responsible for all financial obligations incurred up to the date of such termination. The University agrees to provide me with a pro rata refund, calculated from the date of such termination to the end of the Agreement Period, of any prepaid housing and dining payment made to the University, and to return my Deposit pursuant to this Agreement. Upon resumption of standard operations, Agreement Termination requirements and charges will apply as described in Section XIV.

  • Emergency Calls IP Phones need an additional power supply to operate. In the event of a power failure it is your responsibility to ensure you have the means to make emergency calls. In accordance with paragraph 13.2, we will not be liable for any loss or damage (financial or otherwise) where you fail to do so.

  • Emergency Preparedness All residents are advised to have an emergency plan. It is recommended that each resident maintain an emergency supply kit consisting of a first aid kit, three-day supply of water, non-perishable food, battery operated radio and flashlight, extra batteries, portable electronic device charger, gloves, and medications.

  • Emergency/Declared Disaster Requirements In the event of an emergency or if Orange County is declared a disaster area by the County, state or federal government, this Contract may be subjected to unusual usage. The Contractor shall service the County during such an emergency or declared disaster under the same terms and conditions that apply during non-emergency/disaster conditions. The pricing quoted by the Contractor shall apply to serving the County’s needs regardless of the circumstances. If the Contractor is unable to supply the goods/services under the terms of the Contract, then the Contractor shall provide proof of such disruption and a copy of the invoice for the goods/services from the Contractor’s supplier(s). Additional profit margin as a result of supplying goods/services during an emergency or a declared disaster shall not be permitted. In the event of an emergency or declared disaster, emergency purchase order numbers will be assigned. All applicable invoices from the Contractor shall show both the emergency purchase order number and the Contract number.

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