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Case Management
SCAN offers Case Management Programs to help our members who are facing health challenges.
Centers for Medicare and Medicaid Services (CMS)
The Federal agency within the Department of Health and Human Services that administers Medicare.
Coinsurance
An amount you may be required to pay as your share of the cost for services or prescription drugs. Coinsurance is usually a percentage (for example, 20%).
Community Resources
Community programs that provide services such as case management, transportation, meals-on-wheels, nutrition programs, counseling, friendly visitor, money management, telephone re-assurance, legal counseling, etc.
Complaint
Any oral or written expression of displeasure with a health plan, provider, or facility. This includes concerns about waiting times, satisfaction with facilities, or the respect paid to consumers. Also known as a Grievance. (See also Appeal, which is a complaint regarding denial of service or payment.)
Consumer Assessment of Health Plans Survey
Consumer Assessment of Healthcare Providers and Systems (CAHPS) surveys ask consumers and patients to report on and evaluate their experiences with health care. The CAHPS program is funded and overseen by the U.S. Agency for Healthcare Research and Quality (AHRQ).
Contracted Medical Group
Physicians organized as a legal entity who have an agreement with SCAN to provide medical services to members. Also known as a Participating Provider Group.
Copayment
An amount you may be required to pay as your share of the cost for a medical service or supply, like a doctor’s visit, hospital outpatient visit, or a prescription drug. A copayment is usually a set amount, rather than a percentage. For example, you might pay $10 or $20 for a doctor’s visit or prescription drug.
Cost Sharing
The cost for medical care paid out of one's own pocket. Examples include co-payments, coinsurance, or deductibles.
Covered Benefit
The general term we use to mean all of the health care services and supplies that are covered by our plan.
