Non- Preferred Provider Preferred Provider Emergency Medical Transportation Home Health Care ODAR Appeal Medically Necessary Grievance DocDNA Co- payment Co- insurance Preauthorization Prescription Drug Coverage Doc360 Emergency Room Care Provider Skilled Nursing Care Durable Medical Equipment ICUE Excluded Services In- network Co- insurance Emergency Services SPIRE Reconstructive Surgery Balance Billing Cirrus In- network Co- payment Hospital Outpatient Care Network Out-of- pocket Limit ACET Non- Preferred Provider Preferred Provider Emergency Medical Transportation Home Health Care ODAR Appeal Medically Necessary Grievance DocDNA Co- payment Co- insurance Preauthorization Prescription Drug Coverage Doc360 Emergency Room Care Provider Skilled Nursing Care Durable Medical Equipment ICUE Excluded Services In- network Co- insurance Emergency Services SPIRE Reconstructive Surgery Balance Billing Cirrus In- network Co- payment Hospital Outpatient Care Network Out-of- pocket Limit ACET
(Print)
B-Non-Preferred Provider
G-Preferred Provider
O-Emergency Medical Transportation
I-Home Health Care
B-ODAR
B-Appeal
N-Medically Necessary
N-Grievance
G-DocDNA
I-Co-payment
O-Co-insurance
B-Preauthorization
I-Prescription Drug Coverage
N-Doc360
I-Emergency Room Care
O-Provider
B-Skilled Nursing Care
G-Durable Medical Equipment
O-ICUE
G-Excluded Services
G-In-network Co-insurance
O-Emergency Services
B-SPIRE
B-Reconstructive Surgery
N-Balance Billing
I-Cirrus
N-In-network Co-payment
O-Hospital Outpatient Care
I-Network
G-Out-of-pocket Limit
I-ACET
