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