Urgent medical condition means a condition that satisfies either of the following:
Urgent medical condition means a medical condition that arises suddenly, is not life-threatening, and requires prompt treatment to avoid the development of more serious medical problems;
Urgent medical condition means a medical condition manifesting itself by acute symptoms that are of lesser severity (including severe pain) than that recognized for an emergent medical condition, such that a prudent layperson, who possesses an average knowledge of health and medicine, could reasonably expect the illness or injury to result in:
Examples of Urgent medical condition in a sentence
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.
Once an expedited Appeal is initiated, clinical review will determine if the Appeal involves an Urgent Medical Condition.
If we determine your claim does not involve an Urgent Medical Condition, we may treat your claim as a non-urgent Pre-Service Claim.
All Medically Necessary Covered Services received in Urgent Care Centers, Retail Clinics or your PCP’s office after-hours to treat an Urgent Medical Condition will be covered by AvMed.
If you are appealing an Adverse Decision that involves an Urgent Medical Condition, you may request an expedited decision by contacting Member Services Monday through Friday between 7:30 a.m. and 9 p.m. at 0-000-000-0000 or 711 (TTY).
More Definitions of Urgent medical condition
Urgent medical condition means a Condition manifesting itself by acute symptoms that are of lesser severity than those recognized for an Emergency Medical Condition, such that a prudent layperson who possesses an average knowledge of health and medicine could reasonably expect the illness or injury to place the health or safety of the Member or another individual in serious jeopardy, in the absence of medical treatment within 24 hours. Examples of Urgent Medical Conditions include high fever, dizziness, animal bites, sprains, severe pain, respiratory ailments and infectious illnesses.
Urgent medical condition means a condition that satisfies either of the following: • A medical condition, including a physical condition, a mental condition, or a dental condition, where the absence of medical attention within 72 hours could reasonably be expected by an individual, acting on our behalf, applying the judgment of a prudent layperson who possesses an average knowledge of health and medicine, to result in: ▪ Placing the Covered Person’s life or health in serious jeopardy; ▪ The inability of the Covered Person to regain maximum function; ▪ Serious impairment to bodily function; ▪ Serious dysfunction of any bodily organ or part; or ▪ The Covered Person remaining seriously mentally ill with symptoms that cause the Covered Person to be a danger to self or others; or ▪ A medical condition, including a physical condition, a mental health condition, or a dental condition, where the absence of medical attention within 72 hours in the opinion of a health care provider with knowledge of the Covered Person’s medical condition, would subject the Covered Person to severe pain that cannot be adequately managed without the care or treatment that is the subject of the coverage decision.
Urgent medical condition means a medical condition manifesting itself by acute symptoms that are of lesser severity (including severe pain) than that recognized for an emergent medical condi- tion, such that a prudent layperson, who possesses an average knowledge of health and medicine, could reasonably expect the illness or injury to result in:
Urgent medical condition. As used in this Section 5, a medical condition for which care has not been rendered, and which if not treated within 24 hours:
Urgent medical condition means any medical condition as defined by an appropriate medical authority through documentation or by direct witness of a clearly visible disablement that poses a serious threat to the life of the person with the medical condition.” Do you have an urgent medical condition? Yes No
Urgent medical condition. A medical (physical, mental, or dental) condition manifesting itself by acute symptoms of sufficient severity (including severe pain) such that the absence of medical attention within twenty-four (24) hours could reasonably be expected by a prudent layperson that possesses an average knowledge of health and medicine to result in:
Urgent medical condition. As used in Section 5: