Glossary of Terms
Types of Provider
Behavioral health or substance use: A provider licensed to help with the prevention and treatment of mental and/or substance use disorders
Dental: A doctor who focuses on evaluating, diagnosing, and/or treating your teeth and any teeth-related issues
Durable medical equipment (DME)/Home health supplies: Rented or purchased medical equipment for use in the home such as walkers, beds, wheelchairs
Facility: A building or place that gives a specific service that may include pharmacy services
Hearing: A provider licensed to help manage hearing loss and other hearing issues
Home Health Agency (HHA): A company whose workers provide care in your home
Home- and community-based provider: A provider who helps members in waiver groups with care in their home or the community
Hospital: A place where you get treatment, services and surgery
Laboratory: Where tests are done to get information about your health
Long-term care: Home-and community-based services to help you live in your home or community instead of a facility
Long-term services and support: Services and supports for long-term care members
Pharmacy: The drugstore or store where you get prescription drugs
Primary care provider (PCP): A family provider who gives regular checkups, cares for you when you’re sick, and refers you to other doctors or providers
Specialist: A doctor or provider whose practice is based on a certain kind of medicine or surgery
Therapies: Treatments to help you with physical, mental and social events
Transportation: The vendor who provides rides to and from provider appointments and health care services
Urgent care: A provider or walk-in clinic with medical help for when your PCP’s office is closed but it’s not an emergency
Vision: Medically needed services for the care of your eyes
Product choices
Select from the drop-down menu; your product (plan) is on your ID card
Learning more about each provider
Each provider record has more information.
The office:
- How far this office is from you
- Map and directions
- Street address
- Office days and hours
The provider/office staff:
- Products (Participated In): What plan/products does this provider offer?
- Provider Gender: Is this provider male or female?
- Languages Spoken: What languages are spoken by the office staff and provider?
- Board Certified: Has your provider taken/passed the industry-related tests?
- Age Range Served: Does this provider only see adults or children?
- Wheelchair Accessible: Is the office built for a wheelchair access?
- Accepting New Patients: Is this provider/office taking new patients?
- Specialties/Services Provided: What medical subject does this provider offer?
- Provider Ethnicity: What race is this provider?
Affiliations
The hospital(s) this provider is contracted with to give services. Each hospital listing includes:
- Hospital name
- Hospital address
- Maps and directions
Compare
Use the “Compare” tool when there is more than one provider offering what you need. You can look at three providers side by side.
Provider information is updated daily and may change. Please ask your provider before scheduling your appointment or getting services if he or she is still with Healthy Blue and accepting new patients.
The following information is reported by each provider:*
- Office location
- Specialty
- Languages spoken
- Affiliations
- Office hours
- Acceptance of new patients
*This information is updated upon request and/or every three years during recredentialing.
Hospital accreditation
A hospital’s accreditation tells you if the hospital has been endorsed (approved) by an outside group. The endorsement process includes a review of hospital’s:
- Policies (written descriptions of how things should be done)
- Processes (step by step actions to complete a task)
- Outcomes (the result of following the policies and processes)
This review helps make sure hospitals are giving safe, quality care. Hospital accreditation reports are online:
The Joint Commission (TJC)
Go to the Quality Check page. Search by hospital name or location. Choose provider or certification from the drop-down box.
Health Care Facilities Accreditation Program (HFAP)
Accredited hospitals are listed by state under the “Accredited Facilities” tab.
National Integrated Accreditation for Healthcare Organization (NIAHO)
Go to “Search Hospitals.” Search by hospital name, state or type of certification.