Developmentally Disabled Program Glossary

A

  • Abuso

    Causar daño a alguien a propósito. Esto incluye gritar, ignorar las necesidades de una persona, lastimar o tocar de forma inapropiada.

  • Apelación

    A formal complaint made where a member is not satisfied with a decision made by UnitedHealthcare Community Plan.

  • Sistema de reducción de costos de atención médica de Arizona (AHCCCS)

    The state agency that manages health care programs and covered health care services provided through contracted health plans.

  • Arizona Long Term Care System (ALTCS)

    An AHCCCS program that delivers long term care to members. Los miembros del ALTCS son personas de la tercera edad con discapacidades físicas o del desarrollo.

B

  • Behavioral Health Crisis

    A situation where, without immediate help, you might hurt yourself or someone else.

  • Servicios de salud del comportamiento

    Behavioral health services may include behavior management, group, family and individual therapy and counseling, and emergency/crisis services.

C

  • Co-payment

    A small charge or fee due at the time covered services are provided.

D

  • DD

    Discapacitado del desarrollo

  • DDD

    Division of Developmental Disabilities

  • Department of Economic Security (DES)

    The state agency that determines if a person is eligible for Medicaid.

E

  • Exámenes de detección, diagnóstico y tratamiento tempranos y periódicos (EPSDT)

    A health care program for children up to age 21.

  • Emergencia

    A situation where a person's health, or the health of an unborn baby, could be threatened. Se necesita ayuda médica inmediatamente.

F

  • Fraude

    Lying in order to receive AHCCCS benefits. Esto incluye mentir acerca de la información personal a fin de calificar para recibir los beneficios del AHCCCS. Los médicos pueden cometer fraude si mienten acerca de los servicios proporcionados y luego envían una factura al AHCCCS.

G

  • Reclamo

    A member's expression of dissatisfaction with any part of their care. Un reclamo se puede hacer por teléfono o por escrito. Los reclamos se deben presentar directamente a UnitedHealthcare Community Plan, no a AHCCCS.

H

  • Información de salud

    Facts about a member's health care. UnitedHealthcare Community Plan o un proveedor pueden recibir o crear esta información. Incluye información sobre el estado físico y mental de un miembro, y pagos por la atención médica.

  • Health Insurance Flexibility and Accountability Act (HIFA)

    Offers health care coverage to families with and without children who do not qualify for Medicaid.

  • Healthcare Power of Attorney

    Someone to whom you have given the authority to make health care decisions for you if you cannot make them (usually a close friend, relative or spouse).

  • High-risk pregnancy

    A pregnancy for which the mother or baby may be at higher risk for illness or death.

K

  • KidsCare

    AHCCCS program that provides health care coverage to children under age 19. KidsCare brinda atención a niños que no tienen seguro de salud y no califican para Medicaid.

L

  • Licensed midwife

    A person licensed by the Arizona Department of Health Services to provide maternity care. Esto no incluye a las parteras certificadas.

  • Testamento en vida

    A document where you write what you want done with your health care. El médico lo usa en caso de que usted no pueda expresarse. Enumera los tratamientos específicos que usted desea recibir y los que no. También puede informar a su médico si desea que se hagan esfuerzos especiales para salvar su vida.

M

  • Mamografía

    Screening exam for breast cancer. Se recomienda para las mujeres mayores de 35 años de edad.

  • Managed Care

    A health plan that works like an HMO. Los servicios cubiertos son proporcionados por proveedores que tienen un contrato con el plan de salud.

  • Atención por maternidad

    Includes medically necessary pregnancy counseling, pregnancy testing, prenatal care, labor and delivery services, as well as care after delivery.

  • Maternity care coordination

    Coordination of the mother's needs to ensure her and her baby receive all the necessary care for a healthy pregnancy and delivery.

  • Clínicamente necesario

    Health care or products that a prudent, or wise, doctor would give to a patient to prevent, diagnose, or treat an illness, injury, disease or its symptoms in a way that follows generally accepted standards for medicine and is not just for the convenience of the patient, physician or other health care provider.

  • Miembro

    An eligible person enrolled in AHCCCS who has selected UnitedHealthcare Community Plan as their health plan.

P

  • Cuidados de posparto

    Health care provided to the mother for up to 60 days after delivery.

  • Practitioner

    Refers to a certified nurse practitioner, midwife, or physician assistant.

  • Preconception counseling

    This counseling focuses on finding and managing risk factors before pregnancy. El objetivo es asegurarse de que la mujer esté sana antes del embarazo.

  • Atención prenatal

    Health care provided during the pregnancy.

  • Receta

    Instrucciones por escrito de un médico sobre medicamentos o tratamientos.

  • Médico de atención primaria (PCP en inglés)

    The doctor who treats the member directly. El PCP puede derivar al miembro a un especialista o ingresar al miembro al hospital. Por lo general, los PCP son médicos de cabecera, internistas, pediatras y, a veces, personal de enfermería y auxiliares médicos, pero pueden incluir a obstetras y parteras certificadas para embarazadas.

  • Autorización previa

    Process by which your PCP or specialist contacts UnitedHealthcare Community Plan for approval to provide special services such as surgery.

  • Proveedor

    Persona o institución que proporciona servicios y tratamientos de atención médica, como un médico, una farmacia, un dentista, una clínica o un hospital.

  • Red de proveedores

    Doctors, specialists, hospitals, pharmacies and other providers who work with UnitedHealthcare Community Plan to provide health care services to UnitedHealthcare Community Plan members.

R

  • Derivación

    Process by which your PCP requests additional care for you from a specialist.

  • Regional Behavioral Health Authority (RBHA)

    Place where you go for behavioral health services.

S

  • Seriously Mentally Ill (SMI)

    Any person who, as a result of a serious mental disorder, has emotions or behaviors that prevent them from performing everyday activities.

  • Área de cobertura

    A geographic area, usually one or two adjoining counties, where UnitedHealthcare Community Plan has a contract with AHCCCS to arrange covered health care services to members enrolled with UnitedHealthcare Community Plan.

  • Sixth Omnibus Budget Reconciliation Act (SOBRA)

    An eligibility category for pregnant women and children of certain ages. La elegibilidad se basa en diferentes niveles federales de pobreza. Si está embarazada, comuníquese con el Departamento de Seguridad Económica para saber si es elegible. Comuníquese con su trabajador social del Departamento de Seguridad Económica para que lo ayude a determinar si alguno de sus hijos es elegible.

  • Special Health Care Needs

    Members who have serious and chronic physical, developmental or behavioral conditions who require a special type or amount of care.

  • Especialista

    Cualquier médico que tiene una capacitación especial para tratar una enfermedad o afección en particular. UnitedHealthcare Community Plan: El plan de salud del AHCCCS en el que está inscrito para ayudarlo a recibir los tratamientos y los servicios de atención médica clínicamente necesarios para usted.

U

  • Atención urgente

    Care provided to members when their situation is not life threatening, but cannot wait until the next day for treatment.

W

  • Women, Infants and Children (WIC)

    A community program that provides food, nutrition counseling and access to health services to low income women, infants and children.

Volver a la parte superior de la página

Powered by Translations.com GlobalLink OneLink Software