Stabilization Services Sample Clauses

Stabilization Services. HMO must pay for emergency services performed to stabilize the Member as documented by the Emergency physician in the Member's medical record. HMOs must reimburse for physician's services and hospital's emergency services including the emergency room and its ancillary services. With respect to an emergency medical condition, to stabilize is to provide such medical care as to assure within reasonable medical probability that no deterioration of the condition is likely to result from, or occur during discharge, transfer, or admission of the Member from the emergency room.

Stabilization Services. When the medical screening examination determines that an emergency medical condition exists, HMO must pay for emergency services performed to stabilize the Member. The emergency physician must document these services in the Member's medical record. HMOs must reimburse for both the physician's and hospital's emergency stabilization services including the emergency room and its ancillary services.

Stabilization Services. Services provided to Medicaid-enrolled individuals who are experiencing a mental health crisis must be provided in the person's own home, or another home-like setting, or a setting which provides safety for the individual and the Mental Health Professional. Stabilization services must include short-term (less than two weeks per episode) face-to-face assistance with life skills training, and understanding of medication effects . This service includes: a) follow up to crisis services; and b) other individuals determined by a Mental Health Professional to need additional stabilization services. Stabilization services may be provided prior to an intake evaluation for mental health services.

Stabilization Services. Services provided to Individuals who are experiencing a behavioral health crisis. These services are to be provided in the Individual's own home, or another home-like setting, or a setting which provides safety for the Individual and the MHP/CDP. Stabilization services must include short-term (less than two (2) weeks per episode) face-to-face assistance with life skills training and with the understanding of medication effects and side effects. This service includes: a) follow up to crisis services; and b) other Individuals determined by a MHP/CDP to need additional stabilization services. Stabilization services may be provided prior to an intake evaluation for behavioral health services. This service may include cost for room and board;

Stabilization Services. When the medical screening examination determines that an emergency medical condition exists, HHSC Contract 529-03-042-N 6 of 27 HMO must pay for emergency services performed to stabilize the Member. The emergency physician must document these services in the Member's medical record. HMOs must reimburse for both the physician's and hospital's emergency stabilization services including the emergency room and its ancillary services.

Stabilization Services. For the purposes of the No Surprises Act, post-stabilization services are services provided by an out-of-network provider or emergency facility after a consumer’s emergency medical condition is stabilized. These services must be provided as part of outpatient observation, an outpatient stay, or an inpatient stay. Post- stabilization services are considered to be emergency services under the No Surprises Act unless certain conditions are met, in which case the provisions related to notice and consent to waive balance billing may apply. • Premium – The amount the consumer pays for their health insurance every month. In addition to their premium, the consumer usually has to pay other costs for their health care, including a deductible, copayments, and coinsurance. If a consumer has a Marketplace health plan, they may be able to lower their costs with a premium tax credit. • Provider – An individual or facility that provides health care services. Examples of a provider include a doctor, nurse, chiropractor, physician assistant, hospital, surgical center, skilled nursing facility, and rehabilitation center. A health plan may require the provider to be licensed, certified, or accredited as required by state law. • Qualifying Payment Amount (QPA) – An amount that is generally based on a median contracted rate for an item or service that a health plan pays to providers who are in the same or similar specialty within a geographic area.

Stabilization Services. “Stabilization Services” (also referred to as Crisis Stabilization), means services provided to individuals who are experiencing a Behavioral Health crisis. This service includes follow-up after a crisis intervention. These services are to be provided in the person's own home, or another home-like setting, or a setting that provides safety for the individual and the Behavioral Health Professional. Stabilization Services may include short-term assistance with life skills training and understanding of medication effects. It may also include providing services to the Enrollee’s natural and community supports, as determined by a Behavioral Health Professional, for the benefit of supporting the Enrollee that experienced the crisis. Stabilization services may be provided prior to an intake evaluation for Behavioral Health services. Stabilization services may be provided by a team of professionals, as deemed appropriate and under the supervision of a Behavioral Health Professional.

Stabilization Services. Covered services related to an emergency medical condition that are provided after a Member is stabilized in order to maintain the stabilized condition, or under the circumstances described in 42 CFR 422.114(3), to improve or resolve the Member's condition. (Part H, 3.01-3.35) 07 HUSKY A 05/07 A Medicaid recipient who is subject to enrollment in a managed care organization but is not yet a Member of a specific MCO. A licensed health care professional responsible for performing or directly supervising the primary care services of Members.

Stabilization Services. When the medical screening examination determines that an emergency medical condition exists, HHSC Contract 529-03-037-H