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

Partial Day Treatment: A program offered by appropriately licensed psychiatric facilities that includes either a day or evening treatment program for mental health or substance abuse. Such care is an alternative to inpatient treatment.

Participating Provider: A hospital, doctor, pharmacy, or other provider designated by a health plan to provide care or services to members. Benefits are available only for covered services and must be within the scope of the provider's license. For certain benefits, a participating provider may include a facility, agency, or organization that has an agreement with the plan to provide services to covered members  See also Network provider

PCP: See Primary Care Physician

Per Admission Copay: The fixed-dollar amount that is due and payable by the member for an admission to the hospital inpatient setting.

Physical Therapy: Treatment involving physical movement to relieve pain, restore function and prevent disability following disease, injury, or loss of limb.

Place of Service: Location that a service is rendered to a member. Examples include inpatient hospital doctor's office, ambulatory surgery center, and outpatient hospital.

Plan Benefit Maximum: See Lifetime Maximum

Plastic Surgeon: A plastic surgeon specializes in cosmetic and/or reconstructive surgery of the face and body. Plastic surgeons are certified by the American Board of Plastic Surgery - an ABMS (American Board of Medical Specialties) member board.

Plastic Surgery: Plastic surgery is a field of medical practice that concentrates on both the enhancement and refinement of specific features of the body, as well as restoring or reconstructing facial or body parts.

Point of Service (POS): A product line that combines the cost and care management strengths and comprehensive benefits of an HMO with the freedom of choice of a preferred provider organization. The member determines the benefit level by choosing the point of service - in or out of network.

Polarity Therapy: A manual therapy that combines the holding of pressure points and gentle stretching to balance the body's energy.

Policy Type: Name of the BCBSNC health plan and the associated covered services.

Preferred Provider Organization (PPO): A health plan that contracts with various physicians and hospitals. Enrollees are offered a financial incentive to use providers on a preferred list, but many use non-network providers as well.

Pre Authorization: A procedure used to review and assess the medical necessity and appropriateness of elective hospital admissions and non-emergency outpatient services before the services are provided.

Pre-Certification: Utilization management program that requires the individual or provider to notify the insurer before hospitalization or surgical procedures.

Pre-Existing Condition: A condition, disease, illness or injury for which medical advice, diagnosis, care or treatment was received or recommended within a specified time period prior to enrolling in health plan. Pregnancy and genetic information are not considered pre-existing conditions.

Preferred Brand Drugs: Brand name drugs that are clinically effective, cost effective and meet the needs of most patients.

• This is the second-lowest copayment

Premium: The amount paid to keep an insurance policy active.

Prescription: A written order or refill notice issued by a licensed medical profession for drugs which are only available through a pharmacy.

Preventive Care: Medical services related to the prevention of disease, provided by or upon the direction of a doctor or other provider.

Preventive Care Copay: The fixed-dollar amount that is due and payable by the member at the time a Level 1 covered preventive care service is provided by primary care or specialist physician in the office setting.

PRK (Photorefractive Keratectomy): A corrective laser vision technique that uses a series of laser pulses to reshape the surface of the cornea.

Primary Care Copay: The fixed-dollar amount that is due and payable by the member at the time a Level 1 covered primary care service is provided in the office setting.

Primary Care Physician (PCP): A doctor selected by the enrollee to be the first physician contacted for any medical problem. The doctor acts as the patient's regular physician and coordinates any other care the patient needs, such as a visit to a specialist or hospitalization.

Prior Authorization: The process of obtaining advanced approval of coverage for a health care service or medication. Also called Pre-Authorization.  See also Prior approval

Prorated maximum calendar year HSA contribution: The maximum amount you can contribute based on the month when your insurance policy became effective.

Prosthetic Devices: Fixed or removable artificial limbs or other body parts, which replace absent natural ones.  See also Prosthetic Appliances

Provider: A hospital, non-hospital facility, doctor or other provider, accredited, licensed or certified where required in the state of practice, performing within the scope of license or certification. All services performed must be within the scope of license or certification to be eligible for reimbursement.

Provider Name: The group or entity provider name under which claims are filed to BCBSNC.

Provider Network: A set of providers contracted with a health plan to provide services to the enrollees. In the case of a "fee-for-service" or non-network health plan, the provider network is generally all licensed providers of covered services.