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PEBP CONSUMER DRIVEN HEALTH PLAN MASTER PLAN …
outpatient surgery. The testing must be related to the sickness or injury for which admission or surgery is planned. If a free-standing, non -hospital-based outpatient laboratory facility is not available within 50 miles of your residence, you may use a hospital-based laboratory facility or hospital-based draw station. See the
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Dental Claim Form 2011 - pebp.state.nv.us
pebp.state.nv.usADA Dental Claim Form Header Information 1. Type of Transaction (Check all applicable boxes) Statement of Actual Services—OR— Request for Predetermination/
HEALTH CARE & DEPENDENT CARE REIMBURSEMENT …
pebp.state.nv.usThe expenses listed above were incurred by me and/or my eligible dependents and qualify for reimbursement. 2. The expenses listed above are not eligible for reimbursement by any health care …
MEETING NOTICE AND AGENDA - pebp.state.nv.us
pebp.state.nv.usMEETING NOTICE AND AGENDA AGENDA 1. Open Meeting: Roll Call 2. Public Comment Public comment will be taken during this agenda item. No action may be taken on any matter raised under this item unless the matter is included on a future agenda as an item on which action may be
PEBP FLEXIBLE SPENDING ACCOUNT (FSA) HEALTH CARE …
pebp.state.nv.usA Limited Purpose/Scope Flexible Spending Account is a savings option for active employees covered under the PEBP Consumer Driven Health Plan (CDHP) with a Health Savings Account (HSA).
PEBP CONSUMER DRIVEN HEALTH PLAN MASTER PLAN …
pebp.state.nv.usdocumentation that the product purchased is a Special Food Product or Enteral Formula may be required before the Plan will reimburse for the cost associated with Special Food Products or Enteral Formulas. Page : 142. Free-Standing Laboratory Facility: Free-standing laboratory facilities are stand-along facilities that are
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Cervical and Lumbar Spinal Procedures, MPM 25 - phs.org
www.phs.orgprecertification. Musculoskeletal Surgery Services rendered through the Emergency Room are not managed by NIA. All other inpatient and outpatient Musculoskeletal surgery procedures are managed by NIA for the surgeries outlined below. This Medical Policy includes information on the following items (Ctrl+Click to select): Lumbar Spine Surgery