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UnitedHealthcare Community Plan
UnitedHealthcare Community Plan

UnitedHealthcare Community Plan -
MO HealthNet Managed Care

Glossary

 

A

Advance Directive - An advance directive allows you to leave written directions about your medical

treatment decisions and/or ask someone to decide your care for you.

ASC/SPU - Ambulatory Surgical Center / Short Procedure Unit. 

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B

Benefits - Services, procedures and medications that UnitedHealthcare Community Plan will cover for you.

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C

Clinical Care Management - One-on-one help by a nurse providing education and coordination of UnitedHealthcare Community Plan benefits, tailored to your needs.

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D

Disenrollment - To stop your membership in UnitedHealthcare Community Plan.

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E

Emergency - A condition that requires medical attention right away.

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F

Federal Poverty Level (FPL) - Poverty income thresholds by family size that are annually updated by the Census Bureau.

Fraud - An untruthful act – an example is someone other than you using your UnitedHealthcare Community Plan member ID card and pretending to be you.

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G

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H

Home Health Agency - A company hired by UnitedHealthcare Community Plan to provide care for you in your home.

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I

ID card - Identification card – a card that says you are a a card that says you are a UnitedHealthcare Community Plan member and/or a member of MO HealthNet.  You should have these cards with you at all times.

Informed Consent - You agree to all medical treatments.

Inpatient - When you are admitted into a hospital for a length of time.

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J

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K

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L

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M

Medical Necessity - Your health care provider decides if a treatment, admission, procedure, medical supply, equipment, service, or supply is medically necessary.

Member - A person who is eligible for UnitedHealthcare Community Plan

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N

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O

Outpatient - When you have a procedure done that does not require a hospital stay overnight.

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P

Provider - Any medical professional that UnitedHealthcare Community Plan has contracted with to take care of you.

Provider Directory - A list of providers who participate with UnitedHealthcare Community Plan to help take care of your healthcare needs.

Primary Care Physician (PCP) - A doctor you choose to be your family physician. They have their own private practices.

Preauthorization or Prior Authorization - Your MO HealthNet Managed Care health plan’s method of pre-approving certain services.

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Q

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R

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S

Special Needs Unit (SNU) - A voluntary service offered by UnitedHealthcare Community Plan that can give you extra help in understanding and using your benefits if you have a disability or other special need.

Specialist - A doctor that has specific, detailed training in one certain medical field.

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T

Treatment - The care that you may receive from doctors and facilities.

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U

Urgent care - Urgent care appointments for physical or behavioral illness injuries which require care immediately but are not emergencies such as high temperature, persistent vomiting or diarrhea, symptoms which are of sudden or severe onset but which do not require emergency room services, you must been seen within twenty-four (24) hours.

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V

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W

WIC - Women, Infants and Children program, a supplemental nutrition program that provides nutritious food, education support and health care referrals for women, infants and children.

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X

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Y

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Z

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