Screening for Breast Cancer Blue Cross and Blue Shield of North Carolina is an independent licensee of the Blue Cross and Blue Shield Association. The policies were effective September 1, 2010 for Blue Medicare HMO and Blue Medicare PPO plans. Blue Cross Blue Shield of Massachusetts also offers insurance, pharmacy coverage, and Medicare Plans for seniors; life and disability insurance through Indigo Insurance Services (a wholly owned subsidiary); and insurance for individuals aged 18-26 years. Fraud and Abuse New health problems discussed with your doctor during your visit, Diagnoses that need to be addressed such as high blood pressure, diabetes, skin rash, and headaches, Breast cancer mammography screenings for women over age 40, Colorectal cancer screening for adults over age 45, Cholesterol screening for adults of certain ages or at higher risk, Additional testing and follow-up procedures if abnormalities are found during mammography or colorectal cancer screenings, Request for a vitamin Dlevel check to test for bone and muscle development and function, Request for a vaccination filter test to determine acceptable amounts of vaccine antibodies in the bloodstream. One of the goals of this program is to help contain health care costs. You will be going to a new website, operated on behalf of the Blue Cross and Blue Shield Service Benefit Plan by a third party. Side-to-side and top-to-bottom images are made. One its drawbacks is breast tissue can overlap during compression. Blue Cross NC has partnered with American Imaging Management, Inc. (AIM) for the management of outpatient, high-tech diagnostic imaging services. By using X-rays, they create two-dimensional images of the breast to spot suspicious tissue that may be cancerous. 2023 Blue Cross Blue Shield of North Dakota, Please wait while your form is being submitted, Directory Validation Instructions (No Surprises Act), Recredentialing & Credentialing Applications. You should call the number on the back of your member ID card for more information before you schedule one. Since these are preventive care visits, there is no cost when seeing a Preferred provider for both Basic and Standard Option members. For most women, mammogram technology is still considered the best way to detect breast abnormalities and cancers early. The average mammogram appointment is just 15 minutes long. Cancer screenings like colonoscopies and mammograms. Please review the terms of use and privacy policies of the new site you will be visiting. Non-Discrimination Statement and Foreign language Access. Lumps can be very difficult to feel on your own, which is why its recommended that women over the age of 40 receive regular mammograms. To be covered with no out-of-pocket costs, the service must be: Special information for employees of religious organizations. But Humana, which I have now, is even worse because I have a $50 copay just for screening." 3. Enroll Now. Who Should Get It: Women age 40 and older, Who Should Get It: Age 50 - 80 and high risk due to smoking or other exposure, Who Should Get It: Age 10 - 24 with fair skin, Who Should Get It:Women who have personal or family history of breast, ovarian, tubal or peritoneal cancer or ancestry associated with breast cancer susceptibility, Who Should Get It:High-risk women age 35 and older without a prior diagnosis of breast cancer, ductal carcinoma in situ, or lobular carcinoma in situ, Who Should Get It:Women age 5059 under certain conditions, Who Should Get It:Adults aged 35 to 70 who are overweight or obese; certain women after pregnancy, Who Should Get It: Age 18 and older if at increased risk, Who Should Get It:Women age 65 and older, younger high-risk women, Who Should Get It:Adults aged 40-75 with certain risk factors, Who Should Get It:Pregnant women/women who have delivered a baby recently, Who Should Get It:Pregnant women at high risk for Preeclampsia, Who Should Get It: Pregnant and postpartum women, Who Should Get It: Women planning or capable of pregnancy, Who Should Get It:Sexually active women 24 years or younger and in women 25 years or older who are at increased risk of infection, Who Should Get It:Women who are sexually active or thinking about becoming sexually active. Mammograms are the best way to screen for breast cancer and can detect cancer up to three years before other signs and symptoms appear. Under the benefits of certain plans, the following diagnostic imaging services that are received in an outpatient setting, such as in a medical office, the outpatient department of a hospital or at a freestanding imaging center may require prior approval (for dates of service on or after February 15, 2007 for Blue Cross NC commercial plans and September 1, 2010 for Blue Medicare HMO and Blue . Inscribirse ahora! BATON ROUGE - October is Breast Cancer Awareness Month. Talking with your healthcare provider about the . Take advantage of preventive care and stop problems before they get serious. Health Insurance Tax Information; Transparency in Coverage; Mental Health Parity; Teledentistry Services Covered; . The scans take detailed X-ray images from many angles. The goal of the diagnostic imaging program is to improve affordability of health care to Blue Cross NC members. We believe that it is critical to carefully examine the appropriate use of outpatient, nonemergency diagnostic imaging procedures to make sure that the benefit of the procedure outweighs the risk. Approve annually starting at age 30; Individuals not yet tested for BRCA gene, but with known BRCA mutation in first degree relative. Mammograms use very small doses of radiation and the risk of harm is very low. Who Should Get It: Sexually active women 24 years or younger and in women 25 years or older who are at increased risk of infection, Who Should Get It:Women at high risk of infection or pregnant women, Who Should Get It:Persons at high risk of acquiring HIV, Who Should Get It:Women to age 65 or older if at increased risk, Who Should Get It:Women at high risk of infection and pregnant women, Who Should Get It:Age 18 and older, including pregnant women, Who Should Get It:Women of reproductive age, Who Should Get It:Age 18 and older; when pregnant, Who Should Get It:Women, dependent children up to age 26, pregnant women, Who Should Get It:Women aged 40 to 60 years with normal or overweight body mass index (BMI) of 18.5 - 29.9. Women ages 40 and older can receive a mammogram (four views) each calendar year. Domestic Travel When traveling outside of Vermont you may need access to medical services. Focusing on the right test at the right time for the right patient could save time and mone and increase productivity. You must be at least 18 years old to submit a request. Tests that do not meet national clinical guidelines will not be approved. Our goal is to review diagnostic imaging tests to determine if each test is clinically appropriate for the specific situation. 2005 - 2022 copyright of Anthem Insurance Companies, Inc. One option is Adobe Reader which has a built-in reader. Nothing to fear: Its normal to feel scared before any medical procedure, but theres nothing to worry about! Most basis mammogram screenings are covered by your health plan. As North Dakotans, we can do better in checking for breast cancer. For screening examination to detect breast cancer in. Forgot User ID? Note: The Illinois Insurance Code requires all health insurers to provide coverage for mammography, including: one baseline study age 35-39, and an annual mammogram for women 40 and older. Here's a deeper dive on the potential benefits and risks of a 3D mammogram. Frequency: In women age 21-29 with cervial cytology (pap test) every 3 years. Some Blue Cross NCmembers who are employees of religious organizations and their dependents: Talk to your employer or check your benefit booklet to confirm your coverage for these benefits and any limitations. Based on clinical criteria, AIM will issue a prior approval number or will forward requests to a nurse or physician if they require further review. Register Now, Ancillary and Specialty Benefits for Employees. About 10% of patients who receive routine mammograms get called back for another look. hb```,z@ (Mf`X b`Fe~F9}mS6.awa`\V_RQ g-e0 Health plans are offered by Blue Shield of California. Summary of Arkansas Blue Cross Blue Shield and Health Advantage Coverage Polices. Research shows 3D mammography (breast tomosynthesis) can detect breast cancer 28% more accurately than standard mammograms. By continuing to use this website, you consent to these cookies. How do 3D Mammograms Differ From Standard Ones? Blue Cross and Blue Plus plans cover these eligible preventive services for women ages 12-64, with no member cost sharing when obtained at the in-network level*: Alcohol and substance misuse counseling. You can also visit our Mental Health Resource . Linked Apps. Additionally, we cover computer-assisted detection for those women who seek an extra level of screening for breast cancer. SOURCES: While 3D mammograms show some promise in better health outcomes, there isnt enough research to advocate them over 2D mammograms. The following preventive services and immunizations do not apply to all health plans administered or insured by Blue Cross and Blue Shield of Alabama. Most PDF readers are a free download. Blue Cross and Blue Shield Association. When submitted, the claim will be processed in accordance with the terms of a subscriber's health benefit plan. endstream endobj 105 0 obj <. American Imaging Management (AIM) was selected as a vendor in part due to their track record of creating cost savings while reducing the unnecessary administrative burden on physician offices. Here are some examples: Procedures that may be cosmetic, such as removing scars or excess tissue from your eyes or abdomen; Physical therapy, speech therapy and occupational therapy; Weight-reduction procedures Call the National Information Center at 1-800-411-BLUE (2583) weekdays from 8 a.m. to 8 p.m. Eastern time. It happens in both men and women, but breast cancer in men is not common. The Federal Patient Protection and Preventive Care Act (PPACA) was passed by Congress and signed into law by the President in March 2010. . 122 0 obj <>/Filter/FlateDecode/ID[<13345823F9F84C49978F51E9E4B0DEB3><85AA0C7815CFFF46BE97C496C3A4895B>]/Index[104 37]/Info 103 0 R/Length 89/Prev 75360/Root 105 0 R/Size 141/Type/XRef/W[1 2 1]>>stream To learn if your patient's plan requires prior approval for these services, please reference the diagnostic imaging procedures page. If something is found in a preventive screening mammogram, the screening is still at no cost to the member. Breast Cancer and Early Detection: What Women Need to Know. Ordering physicians may also contact the AIM physician reviewer at any time during the authorization process. . Members must consult their applicable benefit plans or contact a Member Services representative for specific coverage information. (MAMMOGRAPHY) (Coverage Policy 2011018) USPSTF Recommendation. The AIM medical guidelines are publicly available and reviewed regularly by radiologists and practicing physicians of many specialties and updated based on the most current medical evidence. Serving Colorado, Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri (excluding 30 counties in the Kansas City area), Nevada, New Hampshire, Ohio, Virginia (excluding the Northern Virginia suburbs of Washington, D.C.), and Wisconsin. A mammogram uses an X-ray to examine the breast tissue and can detect changes before you can feel them. Insurance. All premiums listed represent coverage for dependents up to age 26. Find A Doctor Or Hospital In Your Network. Yes. Barium enema is a covered service but not at 100% so you may have out of pocket costs. Which health plans does the program apply to? There are many easy-to-use BMI calculators online, such as this example from the Centers for Disease Control and Prevention.*. Understanding Health Care Costs and Quality, Provider Finder -Network Selection Criteria, HMO Provider Network Important Information, Making Your Health Insurance Work For You, Prescription Drug Changes and Pharmacy Information, Machine Readable Files for Transparency in Coverage. Click on a service to see any limits or exclusions. The program will apply to members covered by the following plans: Blue Options SM (group PPO plan), Blue Option HRA (group PPO plan), Blue Options HSA (group and individual PPO plan), Classic Blue (Group CMM plan), Dental Blue (group and individual dental plan), Blue Advantage (individual PPO), Short Term Health Care (individual CMM plan). File is in portable document format (PDF). Necesita su ID de usuario? Frequency: May vary based on your health so ask your doctor, Certain breast pumps for pregnant and post-partum women, One manual or electric breast pump purchase per pregnancy is covered, Benefit available during third trimester (starting 11.1.16) or after member has delivered the baby, Breast pumps come with certain supplies, such as tubing, shields and bottles, Breast pumps must be purchased from participating Durable Medical Equipment (DME) vendors. Has Blue Cross NC considered disallowing self-referrals? The following are the recommended vaccines for women that are covered with no out of pocket cost. Current medical policy is to be used in determining a Member's contract benefits on the date that services are rendered. Call the National Information Center at 1-800-411-BLUE (2583) weekdays from 8 a.m. to 8 p.m. Eastern time. If you have an HMO or POS plan, there are some additional services you'll need approval for. Its common to receive a Pap test (also called a Pap smear or pelvic exam) during your visit. Please review the terms of use and privacy policies of the new site you will be visiting. We'll be completing scheduled maintenance on Sunday (3/5) from 12 a.m. until 6 a.m. Blue Connect may be unavailable during this time. Do practicing North Carolina physicians have input into the program? Hysterectomies are not performed solely for sterilization so are not covered as preventive. 1 If you have gotten one dose of Zostavax vaccine for shingles, you should also get the two doses of Shingrix vaccine. Heres everything you need to know about it. What imaging procedures require prior plan approval? We have an obligation to our members to provide quality care at an affordable price. Usage Agreement to expand insurance coverage for diagnostic mammograms. It's important to note that your provider has the right to code and bill services according to his or her viewpoint. Cat-scan technology exposes patients to more radiation than an X-rays. Mammograms are for older women. http://www.cancer.org/cancer/breastcancer/detailedguide/breast-cancer-key-statistics. Recommended repeated Rh (D) antibody testing for all unsensitized Rh (D)-negative women at 2428 weeks gestation unless the biological father is known to be Rh (D)-negative, Anesthesia services will pay at 100% only for sterilization, Certain services for contraceptive device insertion and removal, such as ultrasounds to confirm IUD placement, will pay at 100%, Pregnancy tests prior to the initiation of contraceptive will pay at 100%. Issuance of a prior approval number is not a guarantee of payment. Blue Cross and Blue Shield of North Carolina does not discriminate on the basis of race, color, national origin, sex, age or disability in its health programs and activities. We can send you an email with information on our health care plans. Confirmation of silicone gel-filled breast implant ruptures, when this diagnosis cannot be confirmed by mammography or breast ultrasound; For postoperative evaluation of silicone breast implant complications. Originally published 11/16/2015; Revised 2019, 2022, Get News & Updates Directly To Your Inbox. Individuals with a known history of Breast Cancer: Approve initial staging, with treatment [within three (3) months], and yearly surveillance for detection of recurrence or a new cancer. No lump, no cancer. Scroll down to see some common services that may or may not be covered during a preventive care visit. When it's diagnostic: If your doctor . Reproduction without authorization from Blue Shield of California is prohibited. During your visit, your doctor will determine what tests or health screenings are right for you based on factors such as your age, gender, health status, and health and family history. Providers can find complete instructions on how to request prior approval outlined on the diagnostic imaging procedures page. No coverage for routine physical examinations. . . Blue Cross and Blue Shield of Louisiana joins other healthcare organizations in reminding Louisianians how important it is to know your personal health risks and ask your doctor about screening. You must also receive prior approval from us. Discover all the ways members can earn wellness incentives and rewards for taking an active role in their health. Usage Agreement Forgot User ID? What imaging procedures do NOT require prior approval? This new site may be offered by a vendor or an independent third party. Another Reason to Get Moving: Exercise Can Help Lower Cancer Risk. Mammograms: Women age 40 and older should have a screening mammogram every year and should continue to do so for as long as they are in good health. "Breast cancer is the most common cancer in American women, but men can also develop breast cancer," said Blue Cross and Blue Shield of . "To put it in perspective, the dose of radiation is lower than that of a chest x . Your doctor will advise on recommended immunizations that can protect against a number of serious diseases. Make sure to get all the screenings and vaccines recommended for your age and gender. Please update your browser if the service fails to run our website. Blue Cross and Blue Shield of North Carolina is an independent licensee of the Blue Cross and Blue Shield Association. For women age 30-65. Screenings, tests and other preventive care services Preventive care service Cost . What places or settings of treatment are affected? Medications covered at 100%: Lovastatin (20 or 40 mg) or Pravastatin (10, 20, 40 or 80 mg). Access Your Payment Options. Forgot Password? What clinical criteria does AIM use to determine if a procedure will be approved? The protection of your privacy will be governed by the privacy policy of that site. Learn more about our non-discrimination policy and no-cost services available to you. All women need to be informed by their healthcare provider about the best screening options for them. Blue Cross and Blue Shield Federal Employee Program Yesterday at 1:00 PM Simple yet warm, this customizable sheet pan lemon-roasted fish . All rights reserved. 18.5 - 24.9: healthy weight. Theyll also look for early signs of breast and cervical cancer. 0 In fact, we rank 32nd out of 50 states. Blue Care Network HMO and POS members. Site Map Even if you're feeling fine, scheduling an appointment with your doctor for preventive care services is important. Who reviews requests for diagnostic imaging prior approval? Compare the prices of 26634 hotels in Ho Chi Minh City, Vietnam. When submitted, the claim will be processed in accordance with the terms of a subscriber's health benefit plan. Coverage is subject to the specific terms of the member's benefit plan. Who can physicians call if they have questions? Yes, they will cover annual mammograms if they are suitable to age. Side-to-side and top-to-bottom images . Find out what preventive care services are appropriate for you and build a list to share with your doctor. Members must enroll in the multi-call program to qualify for up to 12 weeks of NRT. Please utilize the checklist below as a guideline to ensure you have all the necessary information before requesting prior approval: For complex cases, more information may be necessary, including: The diagnostic imaging management process is based upon AIM clinical practice guidelines, developed from consensus opinion in medical practice and integration of medical information from multiple sources, including: The prior approval number will be valid for 30 days from the date issued - not the date of service requested. There is an appeals process in place for unfavorable determinations. Connect Community - Blue Cross and Blue Shield of Illinois, Radiation treatments to the breast or chest area. BSC6.07 Digital Breast Tomosynthesis. Learn the facts, and then schedule an appointment today! No. Negotiated rates with providers can change, therefore, changing the estimate. https://www.anthem.com/health-insurance/health-care-reform-resources/reform-law-detail/more-womens-preventive-care-covered?reformlaw=l1019 Still, over the past decade, there have been advances in mammogram technology. We cover mental health services for transgender and gender-diverse members, whether or not you have a mental health diagnosis. Blue Cross NC will be the fourth company to implement a diagnostic imaging program in North Carolina. This Bronze standard plan premium covers 60% of costs. Breast cancer mammography (at least one baseline mammogram during the 5-year period a member is age 35 through 39 and one mammogram for each member in each calendar year for a member age 40 or older) . The Diagnostic Imaging Management Advisory Group is asked to help develop future phases of the diagnostic imaging program, including addressing over-utilization by self-referring physicians as necessary. Data shows that roughly 30-40% of imaging exams are considered clinically inappropriate or noncontributory. Typical costs: For an uninsured patient, typical full-price cost of a mammogram ranges from $80 to $120 or more, with an average of about $102, according to Blue Cross Blue Shield of North Carolina. Most PDF readers are a free download. Blue Cross and Blue Shield Association . Forgot Password? No lump, no cancer. Evaluation of suspected breast cancer when other imaging examinations, such as ultrasound and mammography, and physical examination are inconclusive for the presence of breast cancer, and biopsy could not be performed (e.g. Medical technology is constantly evolving, and the Company reserves the right to review and update medical policy periodically. Anemia screening for pregnant women. Provider Manual . Am I eligible for these benefits at 100%? Since these are preventive care visits, there is no cost when seeing a Preferred provider for both Basic and Standard Option members. Olvido su contrasea? For this reason, 2D mammograms can sometimes produce inaccurate findings. Blue Cross and Blue Shield of North Carolina does not discriminate on the basis of race, color, national origin, sex, age or disability in its health programs and activities. Your dashboard may experience future loading problems if not resolved. You have coverage from another insurance plan in addition to your Blue Cross and Blue Shield of Nebraska coverage. During this visit, your doctor examines your overall health. Should a member request If you have questions about coverage for preventive services, . Inconclusive screening mammogram due to breast characteristics limiting the sensitivity of mammography . Many travel vaccines are not covered including: Your doctor will determine what tests or health screenings are needed based on your age, gender, and overall health status. Heres everything you need to know about it. Fargo (Headquarters) TheU.S. Preventive Services Task Forcerecommends that women between the ages of 50 and 74 get a mammogram every two years. Wellness service benefits pay you money*. Check out the changes and updates to our plan in 2023. Inscribirse ahora! NRT through QuitlineNC is available without a prescription. Currently, about 12% of women will develop breast cancer at some point in their lifetime. When it's preventive: You get a mammogram to check for breast cancer. If there is a medical reason you cannot use a generic bowel preparation medication, your doctor should review this. Regular mammograms improve survival rates by 35% in women over 50. This policy is designed to address medical guidelines that are appropriate for the majority of individuals with a particular disease, illness, or condition. 2023 Blue Cross and Blue Shield of North Carolina. All rights reserved. Preventive Care Guidelines. Some buy into dangerous myths about breast cancer. The diagnostic imaging management program guidelines are based on the most up-to-date recommendations of physician organizations such as the American College of Radiology and the American College of Cardiology. Diagnostic care includes care or treatment when you have symptoms or risk factors and your doctor wants to diagnose them. Women ages 35-39 can receive one baseline mammogram (four views). Mammograms arent as painful as you think you may feel a little pressure but it only lasts a few seconds. HMO Scope of Benefits Section . The American Cancer Society recommends women ages 40 to 54 get annual mammograms, and women 55 and older get screenings every two years. Log In to the Shopping Cart, Need to Make a Payment? No family history, no risk. You usually need to get tested every 3 to 5 years. AIM has a track record of successful experience working with many providers and other Blue Cross and Blue Shield plans across the country. "Screening" means checking a woman's breasts for cancer before there are signs or symptoms of the disease present. For more information, view our privacy policy. This can get confusing, so call your health plan before you go. Mammograms use very small doses of radiation and the risk of harm is very low. Returning Shopper? This information is a reference tool and does not guarantee payment of any claims. Blue Cross NC is an abbreviation for Blue Cross and Blue Shield of North Carolina. Call the National Information Center at 1-800-411-BLUE (2583) weekdays from 8 a.m. to 8 p.m. Eastern time. As we see trends evolve that may impact patient safety, quality of care or affordability, we must implement solutions that protect our members from these trends. The USPSTF recommends biennial screening mammography for . Standard 2D mammograms take two pictures of the breast. Obesity screenings. The cost of many screenings and checkups is covered at 100% with no out of pocket costs for you and those on your plan. Standard 2D mammograms take two pictures of the breast. We recommend receiving estimates close to . Regular mammograms improve survival rates by, Thanks in part to preventive screenings, there are approximately, The average mammogram appointment is just. Mammograms are one of the best ways to find it early. Council and Blue Cross and Blue Shield of . Routine health checkups. Blue Medicare HMO and Blue Medicare PPO (as of September 1, 2010). Scenario 2: Your claim for emtricitabine/tenofovir (generic Truvada) or Apretude is not paying at 100% and you are using it for PrEP. seen only in single view mammogram without ultrasound correlation); Previous positive breast biopsy within the previous four (4) months and no intervening previous breast MRI; Evaluation of palpable lesion on physical examination and not visualized on ultrasound or mammogram and MRI guided biopsy considered; For evaluation of axillary node metastasis or adenocarcinoma with normal physical examination and normal breast mammogram; Individuals diagnosed with biopsy-proven lobular neoplasia or atypical ductal hyperplasia (ADH); Personal history of or first-degree relative with Le-Fraumeni syndrome (TP53 mutation), Cowden syndrome (PTEN) or Bannayan-RileyRuvalcaba syndrome (BRRS). Likewise, medical policy, which addresses the issue(s) in any specific case, should be considered before utilizing medical opinion in adjudication. For preoperative evaluation for known breast cancer when surgery planned within thirty (30) days; Evaluation of more than two (2) lesions to optimize surgical planning when requested by surgeon or primary care provider on behalf of surgeon who has seen the individual. hrHPV test only every 5 years. , SM Marks of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield Plans. - Ebonie from Chicago, IL [Humana HMO] "I used to have Blue Cross Blue Shield and we didn't have a copay for normal mammograms but even then, I still paid $1700 because the no-cost mammogram lead to ultrasound, another mammogram, and an MRI. Contract language, including definitions and specific inclusions/exclusions, as well as state and federal law, must be considered in determining eligibility for coverage. What information is required to request prior approval? If you don't see your insurance plan listed, please contact our Insurance Hotline at 469-398-4099 or email us at insuranceinfo@solismammo.com. There are also additional guidelines if you're pregnant. Screening mammograms every 12 months if you are a woman age 40 or older. Not all employer groups participate in the diagnostic imaging management program. Approve annually starting at age 30; Individuals with known BRCA mutation. Currently, under the Patient Protection and Affordable Care Act Annual Checkups and certain preventive . When were Blue Cross NC's diagnostic imaging prior approval policies effective? Please check your coverage with your insurance provider before your appointment with us. Screening can help find breast cancer early, when it is easier to treat. Pays cash if you're treated for cancer. Other Adobe accessibility tools and information can be downloaded at https://access.adobe.com. Not all participating DME vendors carry breast pumps. Yes, as of September 1, 2010, all Blue Medicare HMO and Blue Medicare PPO members participate in the program. Women ages 35-39 can receive one baseline mammogram(four views). Approve annually starting at age 30. Under the benefits of certain plans, the following diagnostic imaging services that are received in an outpatient setting, such as in a medical office, the outpatient department of a hospital or at a freestanding imaging center may require prior approval (for dates of service on or after February 15, 2007 for Blue Cross NC commercial plans and September 1, 2010 for Blue Medicare HMO and Blue Medicare PPO plans): Prior approval is not required when these procedures are performed in an emergency room, hospital (related to an inpatient or observation stay), urgent care center or ambulatory surgical center.
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