Professional and Other Services. Manager shall be responsible for arranging and paying for payroll, legal and accounting services related to GROUP operations in the ordinary course of business, including the cost of enforcing any managed care plan, physician or subcontractor contracts, but excluding the cost of malpractice suits.
Professional and Other Services. (Please refer to Your Benefit Schedule for other benefit provisions which may apply.) This Policy provides benefits for Covered Expenses incurred for: Services of a Physician; Services of an anesthesiologist or an anesthetist; Outpatient diagnostic radiology and laboratory services; Radiation therapy, chemotherapy and hemodialysis treatment; Surgical implants, except for cosmetic and dental; Surgical procedures for sterilization (i.e., vasectomy, and or tubal ligations); Prostheses/Prosthetic appliances and devices, artificial limbs or eyes; The first pair of contact lenses or the first pair of eyeglasses when required as a result of eye surgery; Blood transfusions, including blood processing and the cost of unreplaced blood and blood products; Infusion and Injectable Specialty Prescription Medications may require Prior Authorization or pre- certification and Rental or purchase of medical equipment and/or supplies that meet all of the following requirements: • Ordered by a Physician; • Of no further use when medical need ends; • Usable only by the patient; • Not primarily for comfort or hygiene; • Not for environmental control; • Not for exercise; and • And manufactured specifically for medical use. Note: Medical equipment and supplies must meet all of the above guidelines in order to be eligible for benefits under this Policy. The fact that a Physician prescribes or orders equipment or supplies does not necessarily qualify the equipment or supply for payment. Cigna determines whether the item meets these conditions. Rental charges that exceed the reasonable purchase price of the equipment are not covered.
Professional and Other Services. (Please refer to Your Benefit Schedule for other benefit provisions which may apply.) This Policy provides benefits for Covered Expenses incurred for: ▪ Services of a Physician; ▪ Services of an anesthesiologist or an anesthetist; ▪ Outpatient diagnostic radiology and laboratory services; ▪ Radiation therapy, chemotherapy and hemodialysis treatment; ▪ Surgical implants, except for cosmetic and dental; ▪ Surgical procedures for sterilization (i.e., vasectomy, and or tubal ligations); ▪ Prostheses/Prosthetic appliances and devices, artificial limbs or eyes; ▪ The first pair of contact lenses or the first pair of eyeglasses when required as a result of eye surgery; ▪ Blood transfusions, including blood processing and the cost of unreplaced blood and blood products; ▪ Infusion and Injectable Specialty Prescription Medications may require Prior Authorization or pre- certification and ▪ Rental or purchase of medical equipment and/or supplies that meet all of the following requirements: ▪ Ordered by a Physician; ▪ Of no further use when medical need ends; ▪ Usable only by the patient; ▪ Not primarily for comfort or hygiene; ▪ Not for environmental control; ▪ Not for exercise; and ▪ And manufactured specifically for medical use. Note: Medical equipment and supplies must meet all of the above guidelines in order to be eligible for benefits under this Policy. The fact that a Physician prescribes or orders equipment or supplies does not necessarily qualify the equipment or supply for payment. Cigna determines whether the item meets these conditions. Rental charges that exceed the reasonable purchase price of the equipment are not covered.
Professional and Other Services. Manager shall be responsible for arranging and paying for payroll, legal and accounting services related to IPA operations in the ordinary course of business, including the cost of enforcing any managed care plan, physician or subcontractor contracts, but excluding the cost of malpractice suits.
Professional and Other Services
