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UnitedHealthcare Community Plan Medicaid (MMA) Glossary
사전 의료 지시서/사전연명의료 의향서(Advance Directive)
직접 말할 수 없는 경우에 대비하여 미리 의료 관리에 대해 결정한 사항들입니다. This will let your family and your doctors know what decisions you would make if you were able to.
You can file an appeal if you are not happy with a decision we made ("denial"). A denial is when we say no to a service you or your doctor asked us to give you. It could also be when we don't give you as much of a service you wanted. For example, you can file an appeal if your doctor wanted a drug we do not allow. You can also file if we didn't approve a hospital stay. If you are not happy but it is not because we said no to what you asked for, you can file a grievance.
Ambulatory surgical center/short procedure unit.
An approval for a service.
Services, procedures and medications that UnitedHealthcare will cover for you.
Clinical Care Management
One-on-one help by a nurse providing education and coordination of UnitedHealthcare benefits, tailored to your needs.
To stop your membership in UnitedHealthcare.
When you reasonably believe that your health is in serious danger.
신뢰할 수 없는 행동(예: 본인이 아닌 다른 사람이 가입자 ID 카드를 사용하여 그 사람인 척 하는 것).
You can file a grievance when you are not happy. This can be when you are not happy with our plan, or our providers, or anything other than an "action". For example, you may file a grievance if you have a problem making an appointment with a provider or have trouble finding a provider. You can file if you think you are not getting good care. You can also file if a doctor is sending you bills for services you get with our Plan. You can file an appeal If you are not happy with a decision we made (an 'action') (see Appeal).
Home Health Agency
A company contracted by UnitedHealthcare to provide care for you in your home.
Identification card – a card that says you are a UnitedHealthcare member. 이 카드를 항상 소지해야 합니다.
Doctors give you information about a particular treatment or test in order for you to decide whether or not you wish to have the treatment or test.
일정 기간 병원에서 생활하도록 허가되는 경우입니다.
Your health care provider decides if a treatment, admission, procedure, medical supply, equipment, service or supply is medically necessary.
A person who is eligible for UnitedHealthcare.
병원에 입원할 필요가 없는 치료를 받는 경우입니다. In some cases, you may stay overnight in the hospital but not be admitted as an inpatient.
주치의 서비스 제공자(PCP)
A doctor you choose to be your family physician. They have their own private practices.
The process for any service that needs an approval from UnitedHealthcare before it can take place.
Any medical professional that UnitedHealthcare has contracted with to take care of you.
의료 서비스 제공자 주소록
A list of providers who participate with UnitedHealthcare Community Plan to help take care of your healthcare needs.
When you and your primary care doctor agree you need to see another doctor, your primary care doctor will send you to a UnitedHealthcare specialist.
진료 의뢰서를 받기 위해 주치의 서비스 제공자를 만날 필요가 없는 서비스입니다.
A doctor that has specific, detailed training in one certain medical field.
The care that you may receive from doctors and facilities.
When you need care, treatment or medical advice within a 24-hour time period.
Supplemental Food Program for Women, Infants and Children which provides nutrition counseling, nutrition education, and nutritious foods to pregnant and postpartum women, infants and children up to the age of 2. Children deemed nutritionally deficient are covered up to age 5 if they are low income and are determined to be at nutritional risk.
For more information on 플로리다 Medicaid, download the 플로리다 Medicaid Reference Guide.