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