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Glossary
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Here are definitions of some of the terms that are used throughout the site.
Facelift (Rhytidectomy): "Rhytids" are wrinkles - Rhytidectomy literally means the surgical removal of wrinkles. A facelift normally includes the mid-face/cheek area as well as the neck. This procedure will remove excess skin and usually addresses the underlying muscle and connective tissue or SMAS layer (superficial musculoaponeurotic system), then tighten the remaining skin to return the face to a more youthful presentation. A facelift only addresses sagging and loose skin. It does not change the texture or pigmentation of the facial skin.
Facial Plastic Surgeon: A facial plastic surgeon specializes in cosmetic and/or reconstructive surgery of the head and neck only. In most cases a facial plastic surgeon has been board certified in otolaryngology (ear, nose and throat - ENT) and proceeds to complete the board examination in facial plastic surgery. Facial plastic surgeons are certified by the American Board of Facial Plastic and Reconstructive Surgery, an ABMS equivalent board (has met or exceeded the standards put forth by ABMS).
Facility Name: The name of the facility. How information is collected: Application. When is the information updated: Time of recredentialing or when notified by the Facility.
Facility Services: Covered services provided and billed by a hospital or nonhospital facility. All services performed must be within the scope of license or certification to be eligible for reimbursement.
Fat Soluble Vitamins: Vitamins that dissolve in dietary and body fat (A, D, E, and K). They are metabolized and stored by the body in the same fashion as fats. Because excess fat-soluble vitamins may be stored in the body, several weeks' supply may be consumed in a single dose or meal.
Federal Tax Identifier: The federal identifier under which taxes are filed.
Fee-for-Service Reimbursement: A method of payment to providers on the basis of a charge for each procedure performed, including professional service, laboratory, x-ray, injections, etc.
Feldenkrais Method: A somatic education method taught in an individual or group setting that uses verbal and hands-on guidance to improve posture and flexibility. For more information, visit Feldenkrais Guild of North America. See also Hanna Somatics.
Formulary: See Drug Formulary.
Formulary tiers: BCBSNC uses a group of physicians and pharmacists throughout the state to recommend tier classifications. Each drug in the BCBSNC formulary is classified into one of four tier groups to determine the amount of coverage and copayment each requires. The Tier 4 Formulary applies to most but not all policies. Please refer to your benefit booklet to determine if the Tier 4 Formulary applies to you, or check your BCBSNC ID card for four levels of pharmacy copayment.
- Tier 1: Generic drugs - All generic drugs. Lowest copayment
- Tier 2: Preferred brand drugs - Brand name drugs that are clinically effective, cost-effective and meet the needs of most patients. Second-lowest copayment
- Tier 3: Non-preferred brand drugs - Brand name drugs that do not have a generic equivalent, but have a therapeutic alternative available in Tier 2. Brand name drugs not usually used as the first line of treatment. Brand name drugs that have a generic equivalent. Second-highest copayment
- Tier 4: Specialty drugs - Medications classified by BCBSNC as those that generally have unique uses, require special dosing or administration, are typically prescribed by a specialist provider and are significantly more expensive than alternative drugs or therapies. Highest copayment or coinsurance amount.
Please note:
If a member chooses a brand name drug when a generic equivalent is available, the member typically will be responsible for paying the difference between the cost of the generic drug and the brand name drug in addition to the higher tier copayment, unless the member's physician specifically states that the brand name drug is necessary.
Free Radicals: Also called oxidants, are unstable molecules that can attack the body's cells. Damaging a cell membrane can alter functions like bringing in nutrients, oxygen and water, or expelling wastes. Eventually, free radical damage can kill the cell. Free radicals can be produced by trauma, injury, sunlight, pollution, exposure to toxins, alcohol and cigarette consumption, and some foods. They are also a byproduct of many of the body's natural processes.
Full months covered: The number of full months you have been covered under your policy during the calendar year. For example, for a policy that became effective on June 15, the months covered for the calendar year would actually begin on July 1 and end December 31.
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