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