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Here are definitions of some of the terms that are used throughout the site.
Occupational Therapy: See Short-Term Rehabilitative Therapy
Office Visit: Represents the type and level of office visit. Factors that determine the office visit category include complexity of the visit and the time spent with the provider.
Open Enrollment: a) A period during which subscribers in a health benefit program have an opportunity to make changes in their health coverage (select an alternative program, for instance); or b) a period when uninsured individuals can obtain coverage without presenting evidence of insurability (health statements).
OTC: An OTC (over-the-counter) medication is any medication that can be purchased without a prescription. There are OTC medications on the market that effectively treat many common health conditions, including allergies, heartburn, and arthritis.
Over the Counter (OTC): Any medication that can be purchased without a prescription.
Out of Network: Services performed by a provider who has not signed a contract with the member's health plan to be part of a provider network.
Out of Network: With the Blue Options 1-2-3 plan, you may choose to receive covered services from a provider that is not designated as participating in the Blue Options 1-2-3 network, and benefits will be paid at the lower out-of-network level.
Out-of-Network Provider: A provider that has not been designated as a participating or contracted provider by BCBSNC for the member's specific health insurance product.
Out-of-Pocket Costs: Coinsurance payments made by an individual for covered medical services. In addition, this may include deductible amounts for some products, such as Blue Options HSA.
Out-of-Pocket Maximum: Refers to the maximum coinsurance amount that a member is required to pay for covered services during a benefit period. Deductibles, copayments, noncovered services and amounts exceeding the allowed amounts for covered services do not apply to the "out-of-pocket" maximum.
Outpatient: Services received from a hospital or non-hospital facility while not an inpatient.
Outpatient Surgery: Surgical procedures performed that do not require an overnight stay in the hospital or ambulatory surgery facility. Such surgery can be performed in the hospital, a surgery center, or physician office.
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