Harming someone on purpose (this includes yelling, ignoring a person's needs and inappropriate touching).
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.
이의제기/항소
An appeal is a dispute made by a member, his or her representative or a provider with the member's permission, challenging an action by the health plan to deny or limit authorization of a service, including the type or level of service or reduce, suspend, or terminate payment for a previously authorized service; or any failure to authorize services in a timely manner or decide a grievance or appeal within the required time frames.
승인
서비스에 대한 긍정적 의사 표현 또는 승인
B
혜택
Services, procedures and medications that UnitedHealthcare Community Plan will cover for you.
C
Clinical Care Management
One-on-one help by a nurse providing education and coordination of UnitedHealthcare Community Plan benefits, tailored to your needs.
D
Disenrollment
To stop your membership in UnitedHealthcare Community Plan.
DME
내구성 있는 의료 장비 또는 보장구에는 일정 기간 사용해야 하는 휠체어, 보행기, 혈당 측정기, 링거대 등이 포함됩니다. It can also be equipment that must be thrown away such as bandages, catheters and needles. DME must be requested by your doctor.
E
Emergency(응급 상황)
A sudden and, at the time, unexpected change in a person's physical or mental condition which, if a procedure or treatment is not performed right away, could be expected to result in 1) the loss of life or limb, 2) significant impairment to a bodily function, 3) permanent damage to a body part or health of unborn child.
F
사기(Fraud)
신뢰할 수 없는 행동(예: 본인이 아닌 다른 사람이 가입자 ID 카드를 사용하여 그 사람인 척 하는 것).
G
고충/불만사항
A grievance is an expression of dissatisfaction about the health plan, or a practitioner or any matter other than an action taken by the plan. Grievances can include issues with the quality of care or services provided, aspects of interpersonal relationships such as rudeness of a provider or employee, or failure to respect a member's rights.
H
건강 정보
건강 및 관리에 대한 사실입니다. This information may come from UnitedHealthcare Community Plan or a provider. 여기에는 신체 및 정신 건강은 물론 치료 비용에 대한 정보도 포함됩니다.
I
ID Card
An identifcation card that says you are a UnitedHealthcare Community Plan member. 이 카드를 항상 소지해야 합니다.
Immunization
A medicine (usually a shot) that protects, or "immunizes" a member from a disease. 어린이는 연령대에 따라 다른 주사를 맞아야 합니다. 보통 정기적인 검진 중 이러한 주사를 맞습니다.
네트워크 내
Doctors, specialists, hospitals, pharmacies and other providers who have an arrangement with UnitedHealthcare Community Plan to provide health care services to members.
Informed Consent
모든 의학적 치료는 본인에게 설명하며, 본인은 해당 치료를 이해하고 동의합니다.
입원 환자
일정 기간 병원에서 생활하도록 허가되는 경우입니다.
M
가입자
An eligible person enrolled with UnitedHealthcare Community Plan in the Medicaid program.
O
ODJFS
Ohio Department of Job and Family Services
OhioRISE
OhioRISE is a specialized Medicaid health plan for youth with complex behavioral health needs. This program provides behavioral healthcare services to eligible youth. Children and youth who are eligible are under the age of 21 and demonstrate the need for additional behavioral health care as identified through the Ohio Children’s Initiative Child and Adolescent Needs and Strengths (CANS) assessment or a recent inpatient admission for mental health or substance use disorder services.
OhioRISE expands access to in-home and community-based services to ensure eligible children and youth and their families have the tools and supports they need to grow and thrive.
Out-of-Network
Doctors, specialists, hospitals, pharmacies and other providers who do not have an arrangement with UnitedHealthcare Community Plan to provide health care services to members.
P
Prescription
의사가 작성한 의약품 또는 치료에 대한 지시서입니다.
주치의 서비스 제공자(PCP)
가입자에게 개인적인 치료를 하도록 주치의 서비스 제공자로 선정한 의사입니다. Your PCP will coordinate all of your health care.
Prior Authorization
Process that your doctor uses to get approval for services that need to be approved before they can be done. Your doctor must call Utilization Management (UM) at 1-800-366-7304 before you obtain a service or procedure that is listed as requiring an okay.
의료 서비스 제공자 주소록
A list of providers who participate with UnitedHealthcare Community Plan to help take care of your healthcare needs.
Provider or Practitioner
의료관리 서비스를 제공하는 사람 또는 기관(의사, 약국, 치과 의사, 진료소, 병원 등)
R
추천/의뢰/소개
When you and your PCP agree you need to see another doctor and your PCP sends you to a network specialist.
S
Self-Referred Services
Services for which you do not need to see your PCP for a referral.
전문의(Specialist)
특정 상태 또는 질병에 대한 특수 교육을 받은 의사입니다.
U
긴급 치료
응급실 외부에서 사용할 수 있는 병원 응급실 처치의 대체 방법입니다. 건강 상태가 긴급하지만 건강이나 생명에 위협되는 상황은 아닐 때 사용합니다.
W
WIC
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.
