154 lines
5.9 KiB
PHP
Executable File
154 lines
5.9 KiB
PHP
Executable File
<?php
|
||
$this->titre = "INTER-SANTE - ". _("Exclusions standards");
|
||
?>
|
||
|
||
<input class="form-control" style="text-align: center; font-size:11pt;" type="text" value="EXCLUSIONS STANDARDS MEDICARE / EXCLUSIONS FOR MEDICARE" readonly>
|
||
|
||
<table class="table table-striped table-bordered table-hover table-condensed table-responsive" style='font-size:11pt;'>
|
||
<thead>
|
||
<tr>
|
||
<th width="4%" style="text-align: center"> No </th>
|
||
<th width="48%" style="text-align: center"> LES EXCLUSIONS ne sont pas couvertes </th>
|
||
<th width="48%" style="text-align: center"> EXCLUSIONS are not covered </th>
|
||
</tr>
|
||
</thead>
|
||
|
||
<tbody>
|
||
<tr>
|
||
<td align="center"> 1 </td>
|
||
<td align="center"> Tout bilan de santé non motive par une maladie declare sauf pour la grossesse </td>
|
||
<td align="center"> Any voluntary check-up except for pregnancy </td>
|
||
</tr>
|
||
|
||
<tr>
|
||
<td align="center"> 2 </td>
|
||
<td align="center"> Tout les actes, examen ou traitements prescrits pour l’etat de sante tels que la Sterilite, l’impuissance, les malformations ou difformites constitutionnelle </td>
|
||
<td align="center"> Procedure, investigations and treatment prescribed for health conditions such as infertility, impotence malformations or constitutional deformities </td>
|
||
</tr>
|
||
|
||
<tr>
|
||
<td align="center"> 3 </td>
|
||
<td align="center"> Tout les actes, examen ou traitements ayant un rapport avec un avortement provoque </td>
|
||
<td align="center"> Procedure, investigations and treatment related to a voluntary abortion </td>
|
||
</tr>
|
||
|
||
<tr>
|
||
<td align="center"> 4 </td>
|
||
<td align="center"> Tout les actes, examen ou traitements prescrit dans le but esthetique </td>
|
||
<td align="center"> Procedure, investigations and treatment prescribed for for aesthetic purpose </td>
|
||
</tr>
|
||
|
||
<tr>
|
||
<td align="center"> 5 </td>
|
||
<td align="center"> Les produits relevant du confort sexuel (Preservatifs, contaceptifs, des stimulants sexuels, tels que le Viagra et autres,etc.) </td>
|
||
<td align="center"> Sexual comfort products ( Condoms, contraceptive, sexual stimulants as VIAGRA and others, etc) </td>
|
||
</tr>
|
||
|
||
<tr>
|
||
<td align="center"> 6 </td>
|
||
<td align="center"> Les Vitamines( Sauf dans un but curatif dans un etat d’ahypovitaminose), les oligoelements (dans un but curatif dans un etat carentiel), les fortifiants, etc </td>
|
||
<td align="center"> Vitamins (Except for curative purposes in case of Hypovitaminosis); Trace element ( Except for curative purpose in deficiency case and Tonics, etc. </td>
|
||
</tr>
|
||
|
||
<tr>
|
||
<td align="center"> 7 </td>
|
||
<td align="center"> Les prostheses à l’exception des implants d’osteosynthese et des prostheses de chirurgie visceral. </td>
|
||
<td align="center"> Prosthesis except osteosynthesis and visceral surgery implants. </td>
|
||
</tr>
|
||
|
||
<tr>
|
||
<td align="center"> 8 </td>
|
||
<td align="center"> Les prescription depassant une periode de 30 jours sauf si les prescripteurs a ordonne un renouvellement pour le même délai avec une durée maximale de 6 mois </td>
|
||
<td align="center"> Medical prescription exceeding a period of 30 days unless the prescriber has directed a renewals for the same time period with a maximum of six months </td>
|
||
</tr>
|
||
|
||
<tr>
|
||
<td align="center"> 9 </td>
|
||
<td align="center"> Les soins d’orthodontie </td>
|
||
<td align="center"> Orthodontics treatment </td>
|
||
</tr>
|
||
|
||
<tr>
|
||
<td align="center"> 10 </td>
|
||
<td align="center"> Les lentilles de contact, implants oculaires et lentilles intra oculaires. </td>
|
||
<td align="center"> Contact lenses, Ocular implant and intra ocular lenses </td>
|
||
</tr>
|
||
|
||
<tr>
|
||
<td align="center"> 11 </td>
|
||
<td align="center"> Tout les actes, examen ou traitements relatifs a la planification familiale </td>
|
||
<td align="center"> Procedure, investigations and treatment related to Family planning </td>
|
||
</tr>
|
||
|
||
<tr>
|
||
<td align="center"> 12 </td>
|
||
<td align="center"> Les actes relatifs a la prévention comme la vaccination </td>
|
||
<td align="center"> Procedure, investigations and treatment related to Family planning </td>
|
||
</tr>
|
||
|
||
<tr>
|
||
<td align="center"> 13 </td>
|
||
<td align="center"> Les actes relatifs a la prévention comme la vaccination </td>
|
||
<td align="center"> Procedures related to prevention such as vaccination </td>
|
||
</tr>
|
||
|
||
</tbody>
|
||
</table>
|
||
|
||
<input class="form-control" style="text-align: center; font-size:11pt;" type="text" value="AUTHORISATIONS / AUTHORIZATIONS" readonly>
|
||
|
||
<table class="table table-striped table-bordered table-hover table-condensed table-responsive" style='font-size:11pt;'>
|
||
<thead>
|
||
<tr>
|
||
<th width="4%" style="text-align: center"> No </th>
|
||
<th width="48%" style="text-align: center"> Sont remboursés s’il y a eu entente préalable </th>
|
||
<th width="48%" style="text-align: center"> Are reimbursed if there had the prior agreement </th>
|
||
</tr>
|
||
</thead>
|
||
|
||
<tbody>
|
||
<tr>
|
||
<td align="center"> 1 </td>
|
||
<td align="center"> Charge viral de l’Hepatite </td>
|
||
<td align="center"> Hepatitis virus Viral load </td>
|
||
</tr>
|
||
|
||
<tr>
|
||
<td align="center"> 2 </td>
|
||
<td align="center"> Genotype de l’Hepatite </td>
|
||
<td align="center"> Hepatitis virus genotype </td>
|
||
</tr>
|
||
|
||
<tr>
|
||
<td align="center"> 3 </td>
|
||
<td align="center"> Hemodialyse </td>
|
||
<td align="center"> Hemodialysis </td>
|
||
</tr>
|
||
|
||
<tr>
|
||
<td align="center"> 4 </td>
|
||
<td align="center"> MRI , CT-Scan </td>
|
||
<td align="center"> MRI , CT-Scan </td>
|
||
</tr>
|
||
|
||
<tr>
|
||
<td align="center"> 5 </td>
|
||
<td align="center"> Actes spéciaux ou Nouveaux </td>
|
||
<td align="center"> New acts </td>
|
||
</tr>
|
||
|
||
<tr>
|
||
<td align="center"> 6 </td>
|
||
<td align="center"> Intervention Chirurgicales planifiées </td>
|
||
<td align="center"> Planned surgery </td>
|
||
</tr>
|
||
|
||
<tr>
|
||
<td align="center"> 7 </td>
|
||
<td align="center"> Chambre VIP </td>
|
||
<td align="center"> VIP Room </td>
|
||
</tr>
|
||
|
||
</tbody>
|
||
</table>
|