Transfer and Follow-up Care. If a Member is hospitalized in a non-GHC Facility, GHC reserves the right to require transfer of the Member to a GHC Facility, upon consultation between a GHC Provider and the attending physician. If the Member refuses to transfer to a GHC Facility, all further costs incurred during the hospitalization are the responsibility of the Member. Follow-up care which is a direct result of the Emergency must be obtained from GHC Providers, unless a GHC Provider has authorized such follow-up care from a non-GHC Provider in advance. Urgent Care (See Section VIII. for a definition of Urgent Condition.) Inside the GHC Service Area, care for Urgent Conditions is covered at GHC medical centers, GHC urgent care clinics or GHC Providers’ offices, subject to the applicable Cost Share. Urgent care received at any hospital emergency department is not covered unless authorized in advance by a GHC Provider. Care received at urgent care facilities other than those listed above is only covered for Emergency services, subject to the applicable Emergency care Cost Share. Outside the GHC Service Area, Usual, Customary and Reasonable charges are covered for Urgent Conditions received at any medical facility, subject to the applicable Cost Share.
Transfer and Follow-up Care. If a Member is hospitalized in a non-MHCN Facility, GHO reserves the right to require transfer of the Member to a MHCN Facility, upon consultation between a MHCN Provider and the attending physician. If the Member refuses to transfer to a MHCN Facility, all services received will be covered under the Community Provider option of the Inpatient Hospital Services section set forth in the Allowances Schedule. Under the MHCN option, follow-up care which is a direct result of the Emergency must be received from MHCN Providers, unless a MHCN Provider has authorized such follow-up care from a non-MHCN Provider in advance. Follow-up care for services received under the Community Provider option, that is a direct result of the Emergency, is covered subject to the Cost Shares set forth in the Allowances Schedule. Urgent Care (See Section VIII. for a definition of Urgent Condition.) Under the MHCN option, care for Urgent Conditions is covered at MHCN medical centers, MHCN urgent care clinics or MHCN Providers’ offices, subject to the applicable Cost Share. Urgent care received at any hospital emergency department is not covered unless authorized in advance by a MHCN Provider. Under the Community Provider option, charges for Urgent Conditions received at any medical facility are covered subject to the applicable Cost Share.
Transfer and Follow-up Care. If a member is hospitalized in a non-contracting facility, the health plan reserves the right to require transfer of the member to a health plan-contracting facility, when the member’s condition is sufficiently stable to enable safe transfer. If the member refuses to transfer to a contracting facility, all further costs incurred during the hospitalization are the responsibility of the member.
Transfer and Follow-up Care. If a Member is hospitalized in a non-GHC Facility, GHC reserves the right to require transfer of the Member to a GHC Facility, upon consultation between a GHC Provider and the attending physician. If the Member refuses to transfer to a GHC Facility, all further costs incurred during the hospitalization are the responsibility of the Member. Follow-up care which is a direct result of the Emergency must be obtained from GHC Providers, unless a GHC Provider has authorized such follow-up care from a non-GHC Provider in advance. Urgent Care (See Section VIII. for a definition of Urgent Condition.) Inside the GHC Service Area, care for Urgent Conditions is covered only at GHC medical centers, GHC urgent care clinics or GHC Providers’ offices, subject to the applicable Cost Share. Urgent care received at any hospital emergency department is not covered unless authorized in advance by a GHC Provider. Outside the GHC Service Area, Usual, Customary and Reasonable charges are covered for Urgent Conditions received at any medical facility, subject to the applicable Cost Share.
