Here are definitions of some of the terms that are used throughout the site.

Calendar year HSA contribution: The maximum amount you can contribute for the full calendar months that you are eligible to contribute. For example, if you are covered under an HDHP for only six months, then you will only be able to contribute half of the total maximum calendar year amount.

Case Management: A program that is designed to assess the continuing needs of members with catastrophic or chronic health problems. Case managers assist physicians in meeting an individual's health care needs through coordination of services and utilization of resources in order to promote high quality, cost effective outcomes.

Certification: The determination that an admission, availability of care, continued stay or other services, supplies or drugs has been reviewed and, based on the information provided, satisfies our requirements for medically necessary services and supplies, appropriateness, health care setting, level of care and effectiveness.

Cheek Augmentation (Malarplasty): Facial cheek implants are placed to improve the prominence of the cheekbones, to create facial feature harmony after a trauma or to enhance genetically smaller cheekbones. There are several options as to where the incision sites may be placed.

Chemical Peels: A chemical solution ranging from mild to strong is used on the face to soften or improve fine lines, wrinkles, skin tone or irregular pigmentation. Mild peels may be administered by an aesthetician (skin care specialist), whereas a doctor must perform stronger peels.

Chemotherapy: Treatment of malignant disease by chemical or biological antinoeplastic agents.

Chin Augmentation: This surgery is offered to correct a receding or "weak" chin in an effort to bring more balance to the profile. Implants are used to provide greater prominence. Chin augmentation is often accompanied by rhinoplasty surgery (nose reshaping).

Chiropractic Care: Chiropractic medicine is based on the relationship between the structure and function of the human body. Chiropractic care is rendered by a licensed chiropractor and is intended to support the spinal column and nervous system functions.

Claim: A request for payment for benefits received or services rendered.

COBRA (Consolidated Omnibus Budget Reconciliation Act): The federal law applying to groups of 20 or more that offers extended coverage for enrollees and family members after group coverage would normally end. A federal act which requires each group health plan to allow employees and certain dependents to continue their group coverage for a stated period of time following a qualifying event. Qualifying events are those that result in a loss of coverage, such as reduced work hours, death or divorce of a covered employee, and termination of employment.

Coinsurance: Coinsurance is the percentage of the allowed amounts for covered services that BCBSNC will pay after you meet your deductible.

Important Information: Please be aware that some services and supplies received by members in an office setting or in connection with an office visit are in fact provided by hospital-owned or operated practices. These services and supplies may be subject to your deductible and coinsurance. Prior to scheduling an appointment, please confirm with your provider whether the practice is hospital-owned or whether any services are hospital-based and may be subject to deductible and coinsurance.

Coinsurance Maximum: Coinsurance maximum is the total amount of coinsurance that a member is obligated to pay for covered services per benefit period.

Computer Imaging: Computer imaging is state-of-the-art technology allowing a patient to preview the potential outcome of a requested procedure. The patient's image is captured on the computer screen, and the technician "morphs" the features until a desired result is achieved. The computer representation should not be construed as an exact surgical result.

Conscious or IV Sedation: Conscious or IV (intravenous) sedation is the anesthetic approach, which causes the patient to be unaware but does not place him/her under full, general anesthesia.

Continuation: Allowing a covered person who would otherwise lose coverage under a health plan due to certain occurrences such as termination of employment or divorce to retain coverage under specified conditions (see COBRA).

Contraception: Contraceptive devices or medications used in the prevention of pregnancy.

Contract (Subscriber): A legal agreement between an individual subscriber or an employer group and a health plan that describes the benefits and limitations of the coverage. A subscriber could have two contracts (policies) - one for health and one for dental. Can also be called a Benefit Certificate or Policy.

Contract Holder: See subscriber.

Contributions: Money you (or someone else) deposits into your health savings account (HSA). Contributions are tax-deductible, and are subject to annual limitations outlined by the IRS and based on your health plan deductible.

Conversion Option: The exercise of an option to purchase individual coverage at a negotiated rate by a person who is leaving an employee group, typically at retirement.

Coordination of Benefits (COB): The provision which applies when an enrollee is covered by two health plans at the same time. The provision is designed so that the payments of both plans do not exceed 100% of the covered charges. The provision also designates the order in which the multiple health plans are to pay benefits. Under a COB provision, one plan is determined to be primary and its benefits are applied to the claim first. The unpaid balance is usually paid by the secondary plan to the limit of its responsibility. Benefits are thus "coordinated" between the two health plans.

Copayment (or copay): The fixed-dollar amount which is due and payable by the member at the time a covered service is provided.

Important Information: Please be aware that some services and supplies received by members in an office setting or in connection with an office visit are in fact provided by hospital-owned or operated practices. These services and supplies may be subject to your deductible and coinsurance. Prior to scheduling an appointment, please confirm with your provider whether the practice is hospital-owned or whether any services are hospital-based and may be subject to deductible and coinsurance.

Cosmetic Dermatologist: A cosmetic dermatologist is a doctor whose practice focuses on aesthetic or cosmetic procedures/treatments for the skin, such as laser resurfacing, chemical peels, etc. As of this date there is no specific board certification in cosmetic dermatology. Dermatologists are certified by the American Board of Dermatology.

Cosmetic Surgery : Cosmetic surgery focuses mainly on the enhancement or beautification of specific facial or body parts. It does not necessarily include reconstruction or restoration, except in specific cases, such as rhinoplasty-where both function (breathing, etc.) and form (removal of bump, etc.) are addressed.

Cost Sharing: A method of dividing the cost of healthcare among consumers, insurance companies, employers and providers. For example, your employer may pay part of the premiums for your insurance. Your health plan will pay part of your healthcare bills, and you will pay part. If your doctor is part of your health plan's network, then he or she will cover part of the cost by negotiating a discount for his or her services. Everyone shares in the cost to keep costs down.

Covered Service: Service, drug, supply or equipment specified which members are entitled to benefits in accordance with the terms and conditions of health plan.

CranioSacral Therapy: A manual therapy that involves a gentle, non-invasive palpation (touch by the practitioner) of the head, spinal column, and sacrum.

Credentialing: The process of licensing, accrediting, and certifying health care providers. Managed care companies often verify providers' credentials prior to allowing them to participate in a provider network.

Cupping: An Oriental medicine technique which utilizes a glass or bamboo cup to create a suction on the skin above a painful muscle or acupuncture point.

Custodial Care: Care comprised of services and supplies, including room and board and other facility services, which are provided to the patient, whether disabled or not, primarily to assist him or her in the activities of daily living. Custodial care includes, but is not limited to, help in walking, bathing, dressing, feeding, preparation of special diets and supervision over self-administration of medications. Such services and supplies are custodial as determined by BCBSNC without regard to the provider prescribing or providing the services.

Customary and Reasonable (C&R) : See Usual, Customary and Reasonable (UCR) Charge.