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PACPolitical Action Committee
PARParticipating (plan, hospital, physician, etc.)
Partial Day TreatmentA program offered by licensed psychiatric facilities that includes either a day or evening treatment program for mental health or substance abuse. Such care is an alternative to inpatient treatment.
Participating ProviderIndividual physicians, hospitals and professional health care providers who have a contract with CareFirst BlueCross BlueShield and/ or CareFirst BlueChoice, Inc. to provide services to its members at a discounted rate and to be paid directly for covered services.
PCPA physician selected by the member, who is part of the plan network, who provides routine care and coordinates other specialized care. The PCP should be selected from the network that corresponds to the plan in which you are a member. The physician you choose as your PCP may be a family or general practitioner, internist or pediatrician.
PDRPhysicians Desk Reference
PHNPreferred Health Network (of Maryland) -- (Merged into BlueChoice)
Physical TherapyTreatment by a licensed therapist involving physical movement to relieve pain, restore function and prevent disability following disease, injury or loss of limb.
PIMSProvider Information Management System
PIPPersonal Injury Protection/Proposal and Installment Process
Plan Allowance (Allowed Amount or Allowable Charge)The maximum dollar amount a contract allows for services covered, regardless of the provider's actual charge. A provider who participates in the network cannot charge the member more than this amount for any covered service.
Plan Benefit Maximum555-555-0199@example.com
PolicyholderThe employee or member of a group who applies for coverage or applies for coverage on an individual, or has a non-employer-sponsored contract and is the person whose name is on the contract.
POSThese plans include in-network (HMO) and out-of-network (PPO or traditional major medical) options that enable members to select which network and level of benefits they want to utilize at the time services are required.
PPAPreferred Provider Arrangement
PPNPreferred Provider Network
PPOAn agreement between a medical provider and a health care carrier for the delivery of services to a specific member population using discounted fees for cost savings. This relates to only a fee arrangement, and does not imply that any provider is more or less qualified than another.
Pre-AuthorizationApproval necessary for designated procedures or hospital admissions. When care is received in-network, the primary care physician or specialist is usually responsible for obtaining pre-authorization. For out-of-network services, the member is responsible for obtaining pre-authorization.
Pre-Existing ConditionAn illness or condition that you or another member had prior to applying for health insurance. In some cases, these conditions may be subject to a waiting period for benefits or excluded from coverage.
PremiumsPeriodic amounts paid by or on behalf of members for ongoing health care coverage. It does not include any deductibles or copayments the plan may require.
PrescriptionA written order or refill notice issued by a licensed medical professional for drugs or devices (e.g., syringes, needles for diabetics) that are only available through a pharmacy.
Preventive CareCare rendered by a physician to promote health and prevent future health problems for a member who does not exhibit any symptoms. Examples are routine physical examinations and immunizations.
Prior Authorization555-555-0199@example.com
Prosthetic DevicesA device which replaces all or a portion of a part of the human body. These devices are necessary because a part of the body is permanently damaged, is absent or is malfunctioning.
ProviderPerson, organization or institution licensed to provide health care services.
Provider NetworkThe set of providers contracted with a health plan to provide services to the members. In the case of a fee-for-service or non-network health plan, the provider network is generally all licensed providers of covered services.
PTPhysical Therapist
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