Acute care hospital means a Hospital that provides Acute Care Services. Adjudicate means to deny or pay a Clean Claim. Administrative Services see MCO Administrative Services. Administrative Services Contractor see HHSC Administrative Services Contractor.
Home health aide services means the personal care and maintenance activities provided to individuals for the purpose of promoting normal standards of health and hygiene.
Home health aide means an individual employed by a home health agency to provide home health services under the direction of a registered nurse or therapist.
Hospice Care means a coordinated program of active professional
Home health care services means medical and nonmedical services, provided to ill, disabled or infirm persons in their residences. Such services may include homemaker services, assistance with activities of daily living and respite care services.
Home care agency means any sole proprietorship,
Intensive Care Unit means an identified section, ward or wing of a hospital which is under the constant supervision of a dedicated medical practitioner(s), and which is specially equipped for the continuous monitoring and treatment of patients who are in a critical condition, or require life support facilities and where the level of care and supervision is considerably more sophisticated and intensive than in the ordinary and other wards.
Home care services means skilled or personal care
Palliative care means medical service rendered to reduce or moderate temporarily the intensity of an otherwise stable medical condition, but does not include those medical services ren- dered to diagnose, heal or permanently alleviate or eliminate a medical condition.
Child Care Program means a person or business that offers child care.
Respiratory care practitioner means a person who is
PREVENTIVE CARE SERVICES means covered healthcare services performed to prevent the occurrence of disease as defined by the Affordable Care Act (ACA). See Preventive Care and Early Detection Services in Section 3. PRIMARY CARE PROVIDER (PCP) means, for the purpose of this plan, professional providers that are family practitioners, internists, and pediatricians. For the purpose of this plan, gynecologists, obstetricians, nurse practitioners, and physician assistants may be credentialed as PCPs. To find a PCP or check that your provider is a PCP, please use the “Find a Doctor” tool on our website or call Customer Service.
Adult care home means any nursing facility, nursing facility for
Behavioral therapy means interactive therapies derived from evidence-based research, including applied behavior analysis, which includes discrete trial training, pivotal response training, intensive intervention programs, and early intensive behavioral intervention.
Home Health Care Agency means an agency or organization which provides a program of home health care and which:
Drug therapy management means the review of a drug therapy regimen of a patient by one or more pharmacists for the purpose of evaluating and rendering advice to one or more practitioners regarding adjustment of the regimen.
Pharmacy means prescribed drugs and medicines dispensed by a pharmacist and/or travel and allergy vaccines dispensed by a pharmacist or doctor.
Therapeutic care means services provided by licensed or certified speech pathologists, Occupational Therapists and Physical Therapists.
Acute care means preventive care, primary care, and other medical care provided under the direction of a physician for a condition having a relatively short duration.
Participating Hospice Care Program Provider means a Hospice Care Program Provider that either: (i) has a written agreement with the Claim Administrator or another Blue Cross and/or Blue Shield to provide services to participants in this benefits program, or; (ii) a Hospice Care Program Provider which has been designated by a Blue Cross and/or Blue Shield Plan as a Participating Provider Option program.
Home care means care and treatment of an insured under a plan of care established, approved in writing and reviewed at least every 2 months by the attending physician, unless the attend- ing physician determines that a longer interval between reviews is sufficient, and consisting of one or more of the following:
Hospice means a public agency or private organization licensed pursuant to Chapter 400, Florida Statutes, to provide Hospice services. Such licensed entity must be principally engaged in providing pain relief, symptom management, and supportive services to terminally ill Members and their families.
Medical cannabis card means the same as that term is defined in Section 26-61a-102.
Diagnostic Services means services provided for the purpose of determining the nature and cause of a condition, ill- ness, or injury.
Primary care physician means a physician who is a family
Manufactured home community means the same as land-leased community defined in sections 335.30A and 414.28A.