Glossary of Terms

Types of Providers

Behavioral health and substance abuse

 

A provider licensed to help with the prevention and treatment of mental and substance abuse 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, and 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- and community-based provider

 

A provider who helps members in waiver groups with care in their home or the community

Home Health Agency (HHA)

 

A company whose workers provide care in your home

Hospital/Facility

 

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 doctor who gives regular checkups, cares for you when you’re sick, and refers you to other doctors

Specialist

 

A doctor 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 healthcare 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 healthcare product 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 to 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 they are still with Anthem 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 a hospital’s:

  • Policies
  • Processes
  • Outcomes

This review helps make sure hospitals are giving safe, quality care.

 

Hospital accreditation reports are online:

 

To view the hospital accreditation report from The Joint Commission (TJC), visit The Joint Commission's website and go to the Quality Check page. Search by hospital name or location. Choose provider or certification from the drop-down box.

 

To learn more about the accreditation process, visit the ACHC website.

 

To search for accredited hospitals by name, state, or type of certification, visit the DNV website.

 

To read the report from the Commission on Accreditation of Rehabilitation Facilities (CARF), visit the CARF website and search by hospital name. Or go to “Use Advanced Search” and search by the provider’s name.