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To filter by the starting letter, hover your mouse over the "Starting Letter" column title and click the arrow that appears. You can then select the letter for which you wish to see the results for. |
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| A | ACCESS Card | Medical Assistance Identification card. The PA ACCESS card is issued to individuals for MA benefits. The card is one of the methods that may be used by medical providers to verify MA consumer eligibility for medical services through the Eligibility Verification System (EVS) | | A | Acute Care | Short-term care for a person with a single episode of short-term illness or with an exacerbation of a chronic condition. | | A | Adjudicated Claim | A claim that has been processed to payment or denial Administrative Costs - Costs not linked directly to the provision of medical care. Includes marketing, claims processing, bill and medical record keeping among others. | | A | Alternate Payment Name | The person to whom benefits are issued on behalf of an MA consumer | | B | Behavioral Health Care Firm | Specialized (for profit) managed care organizations, focusing on mental health and substance abuse benefits, which they term "behavioral health." These firms offer employers and public agencies a managed mental health and substance abuse benefit. | | B | Behavioral Health Rehabilitation Services for Children and Adolescents | (formerly EPSDT Wraparound) Individualized, therapeutic mental health, substance abuse or behavioral interventions/services developed and recommended by an interagency team and prescribed by a physician or licensed psychologist. | | B | Behavioral Health Services | Mental health and/or drug and alcohol services, which are provided by the BH-MCO. | | C | Capitation | A fixed amount of money paid per person for covered services for a specific time; usually expressed in units of per member per month (pmpm). | | C | Carve-out | A separate contract or sub contract for a certain population such as those with mental health or substance abuse problems. | | C | Case Management Services | Services which will assist individuals in gaining access to necessary medical, social, educational and other services |
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