View a listing of health care abbreviations and acronyms.
- A group of multi-specialty medical groups and individual practice doctors that are contracted to provide services to members of a health plan.
- Network Provider
- A medical provider who has contracted with a health plan as a participating provider.
- Non-Participating Provider
- A medical/ dental provider who has not contracted with a particular health plan within its participating provider network. The member is responsible for the total charge for services rendered. See Participating Provider.
- Not Medically Necessary
- Describes the use of a service or supply which does not meet the criteria for determining medical necessity.See Medically Necessary.