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Glossary of Terms

Types of providers

  • Behavioral health or substance abuse: A provider licensed to practice in 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 supports: 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 health care 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 health care 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 wheelchair 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
  • Map 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 Blue Cross and Blue Shield 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 the hospital’s:

  • Policies
  • Processes
  • Outcomes

This review helps make sure hospitals are giving safe, quality care. Hospital accreditation reports are online:

The Joint Commission (TJC)
www.jointcommission.org
Go to the "Quality Check" page. Search by hospital name or location. Choose provider or certification from the drop-down box.

Health Care Facilities Accreditation Program (HFAP)
www.hfap.org/AccreditedFacilities/index.aspx?FacilityType=HOSPN
Accredited hospitals are listed by state under the “Accredited Facilities” tab.

National Integrated Accreditation for Healthcare Organization (NIAHO)
www.dnvglhealthcare.com/hospitals
Go to “Search Hospitals.” Search by hospital name, state or type of certification.