Health Care Terms
Learn what the terms mean that your provider uses. There are even more word meanings in your Evidence of Coverage (EOC) or Medicaid-Only Member Handbook.
| Term | Definition |
|---|---|
| Behavioral Health Care Coordination Services | This no-cost service pairs you with a Care Coordinator. Our Care Coordinators are nurses, social workers or counselors. You and your Care Coordinator will talk by phone or in-person. They will work with you to define your needs and link you to resources. Your Care Coordinator can help you with health or other life concerns. They can also help you understand your benefits. |
| Inpatient Services | Day treatment is a structured program for adults with mental health conditions. It offers one-on-one and group therapy, and lets you work on your social skills. Services are given in a community setting. It can last a half day or whole day. |
| Partial Hospitalization Program (PHP) Services | PHP is an outpatient therapy program that helps treat mental health conditions. It can also be used to treat substance use disorder (SUD). PHP is given in a hospital or Community Mental Health Center (CMHC) setting. It may be offered if you were recently in the hospital. It includes one-on-one and group therapy. Treatment happens during the day. You do not have to stay overnight. |
| Pharmacological Management | When you work with your provider to make sure your medications are working. This can be things like reviewing and changing your dosage. |
| Preventive Care | Routine care like screenings and exams. You get this care to help stop a health problem from occurring. |
| Prior Authorization | Approval that may be needed before you get a service. The service must be medically necessary for your care. Your provider will take care of this for you. |
| Psychotherapy (family, group, individual) | It is also known as counseling or “talk therapy.” You can talk about your feelings and thoughts with a licensed therapist. You may learn skills to change your behavior, help relationships, and manage your symptoms. These sessions can be one-on-one, with loved ones, or in a group setting. |
| Psychiatric Diagnostic Evaluation | A mental health provider looks at you and your family’s health and social history. They may be a psychiatrist, counselor or social worker. They may diagnose you by what you share with them. They can help you get treatment. They may also link you to other services that can help you. |
| Transcranial Magnetic Stimulation (TMS) | TMS uses magnets to stimulate nerve cells in your brain. It can help improve symptoms of depression. TMS most often happens in an office or outpatient setting. |