UnitedHealthcare Community Plan - Heritage Health Glossary

A

  • Advance Directive

    A decision about your healthcare that you make ahead of time in case you are ever unable to speak for yourself. This will let your family and your doctors know what decisions you would make if you were able to.

  • ASC/SPU

    Ambulatory Surgical Center / Short Procedure Unit .

  • Authorization

    An O.K. or approval for a service.

B

  • Benefits

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

C

  • Clinical Care Management

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

D

  • Disenrollment

    To stop your membership in UnitedHealthcare Community Plan.

E

  • Emergency

    When you reasonably believe that your health is in serious danger.

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.

H

  • Home Health Agency

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

I

  • ID Card

    Identification card – a card that says you are a UnitedHealthcare Community Plan member. You should have this card 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.

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

O

  • Outpatient

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

P

  • Primary Care Physician (PCP)

    A doctor you choose to be your family physician. They have their own private practices.

  • Prior Authorization

    The process for any service that needs an O.K. from UnitedHealthcare Community Plan before it can take place.

  • 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.

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.

T

  • Treatment

    The care that you may receive from doctors and facilities.

U

  • Urgent Care

    When you need care, treatment or medical advice within a 24-hour time period.

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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UnitedHealthcare Community Plan - Heritage Health