Specialist Care/Referrals Sample Clauses

Specialist Care/Referrals. If the Nurse Practitioner feels a healthcare need is outside of the scope of primary care, referral to a specialist will be warranted. Membership in the PRACTICE does not preclude medically necessary specialist evaluation or referral as deemed appropriate by the Nurse Practitioner. If the MEMBER does not agree to follow through on a recommendation for specialist referral by the PRACTICE, the MEMBER will be asked to sign an Against Medical Advice form and the PRACTICE reserves the right to terminate the Member’s membership. It is not the responsibility of the PRACTICE to guarantee discounted specialist pricing. If the PRACTICE does not have information providing specialist cash pricing on hand, it will be the MEMBER’S responsibility to obtain such pricing at the specialist's office.
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Specialist Care/Referrals. If the Provider feels a healthcare need is outside of the scope of family medicine, referral to a specialist will be warranted. Membership in the PRACTICE does not preclude medically necessary specialist evaluation or referral as deemed appropriate by the Provider. The provider may from time to time conduct telephone consultations with specialists on behalf of the patient as part of medical care coordination and at no direct expense, but this shall be at the discretion of the provider and shall not preclude medically necessary specialist referral. If the Member does not agree to follow through on a recommendation for specialist referral by the PRACTICE, the Member will be asked to sign an Against Medical Advice form and the PRACTICE reserves the right to terminate the Member’s membership. Although the PRACTICE may help procure specialist cash pricing for the Member, it is not the responsibility of the PRACTICE to guarantee discounted specialist pricing. If the PRACTICE does not have information providing specialist cash pricing on hand, it will be the Member's responsibility to obtain such pricing at the specialist's office.
Specialist Care/Referrals. If the Provider feels a healthcare need is outside of the scope of primary care, referral to a specialist will be warranted. Membership in the PRACTICE does not preclude medically necessary specialist evaluation or referral as deemed appropriate by the Provider. If the Member does not agree to follow through on a recommendation for specialist referral by the PRACTICE, the Member will be asked to sign an Against Medical Advice form and the PRACTICE reserves the right to terminate the Member’s membership. Although the PRACTICE may help procure specialist cash pricing for the Member, it is not the responsibility of the PRACTICE to guarantee discounted specialist pricing. If the PRACTICE does not have information providing specialist cash pricing on hand, it will be the Member's responsibility to obtain such pricing at the specialist's office.

Related to Specialist Care/Referrals

  • Office Visits (other than Preventive Care Services) This plan covers office and clinic visits to diagnose or treat a sickness or injury. Office visit copayments differ depending on the type of provider you see. This plan covers physician visits in your home if you have an injury or illness that: • confines you to your home; or • requires special transportation; and • because of this injury or illness, you are physically unable to travel to the provider’s

  • Patient Care Resident shall participate in safe, effective, and compassionate patient care, under supervision, commensurate with Resident's level of advancement and responsibility.

  • SPECIALIST SERVICES Medical care in specialties other than family practice, general practice, internal medicine [or pediatrics][or obstetrics/gynecology (for routine pre and post-natal care, birth and treatment of the diseases and hygiene of females)].

  • Urgent Care Services All Medically Necessary Covered Services received in Urgent Care Centers, Retail Clinics or your Primary Care Physician’s office after-hours to treat an Urgent Medical Condition will be covered by AvMed. Any request for reimbursement of payment made by a Member for services received must be filed within 90 days or as soon as reasonably possible but not later than one year unless the Member was legally incapacitated. If Urgent Medical Services and Care are required while outside the continental United States, Alaska or Hawaii, it is the Member’s responsibility to pay for such services at the time they are received. For information on filing a Claim for such services, see Part XIII. REVIEW PROCEDURES AND HOW TO APPEAL A CLAIM (BENEFIT) DENIAL.

  • Specialists Persons working within a juridical person who possess uncommon knowledge essential to the commercial presence’s production, research equipment, techniques or management. In assessing such knowledge, account will be taken not only of knowledge specific to the commercial presence, but also of whether the person has a high level of qualification referring to a type of work or trade requiring specific technical knowledge, including membership of an accredited profession.

  • Training a. The employer, in consultation with the local, shall be responsible for developing and implementing an ongoing harassment and sexual harassment awareness program for all employees. Where a program currently exists and meets the criteria listed in this agreement, such a program shall be deemed to satisfy the provisions of this article. This awareness program shall initially be for all employees and shall be scheduled at least once annually for all new employees to attend.

  • Child Care A. Employees employed as of March 1 who meet the following criteria shall be eligible for a lump sum payment each year. Eligible employees may apply for this payment between March 1 and April 15 of each year. Payment shall be made within thirty (30) days of receipt of the completed application. Any application received after April 15 will be considered on a case by case basis and shall not be arbitrarily rejected.

  • Contract for Professional Services of Physicians Optometrists, and Registered Nurses In accordance with Senate Bill 799, Acts 2021, 87th Leg., R.S., if Texas Government Code, Section 2254.008(a)(2) is applicable to this Contract, Contractor affirms that it possesses the necessary occupational licenses and experience.

  • Tobacco Use Counseling and Intervention This plan covers smoking cessation programs when prescribed by a physician in accordance with R.I. General Law §27-20-53 and ACA guidelines. Smoking cessation programs include, but are not limited to, the following: • Smoking cessation counseling must be provided by a physician or upon his or her referral to a qualified licensed practitioner. • Over-the-counter and FDA approved nicotine replacement therapy and/or smoking cessation prescription drugs, prescribed by a physician, and purchased at a pharmacy. See the Summary of Pharmacy Benefits for details on coverage. Vaccinations/Immunizations This plan covers adult and pediatric preventive vaccinations and immunizations in accordance with current guidelines. Our allowance includes the administration and the vaccine. If a covered immunization is provided as part of an office visit, the office visit copayment and deductible (if any) will apply. Travel immunizations are covered to the extent that such immunizations are recommended for adults and children by the Centers for Disease Control and Prevention (CDC). The recommendations are subject to change by the CDC. Preventive Screening/Early Detection Services This plan covers preventive screenings based on the ACA guidelines noted above. Preventive screenings include but are not limited to: • mammograms; • pap smears; • prostate-specific antigen (PSA) tests; • flexible sigmoidoscopy; • double contrast barium enema; • fecal occult blood tests, screening for gestational diabetes, and human papillomavirus; and • genetic counseling for breast cancer susceptibility gene (BRCA). This plan covers colonoscopies in accordance with R.I. General Laws § 27-18-58. Covered healthcare services include an initial colonoscopy or other medical tests or procedures for colorectal cancer screening and a follow-up colonoscopy if the results of the initial test are abnormal. Contraceptive Methods and Sterilization Procedures for Women This plan covers the following contraceptive services: • FDA approved contraceptive drugs and devices requiring a prescription; • barrier method (cervical cap, diaphragm, or implantable) fitted and supplied during an office visit; and • surgical and sterilization services for women with reproductive capacity, including but not limited to tubal ligation. Breastfeeding Counseling and Equipment This plan covers lactation (breastfeeding) support and counseling during the pregnancy or postpartum period when provided by a licensed lactation counselor. This plan covers manual, electric, or battery operated breast pumps for a female member in conjunction with each birth event.

  • Medical Care Leave An Employee who is unable to make the necessary arrangements for maintenance of personal health care outside of scheduled work time, shall be granted time off with pay. Such time off shall not exceed sixteen (16) working hours per calendar year. Hours in excess of sixteen (16) hours per calendar year shall be deducted from the Employee's sick leave accumulation.

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