AHCCCS: Arizona Health Care Cost Containment System
ALTCS: Arizona Long Term Care System
AzEIP: Arizona Early Intervention Program
CRS: Children Rehabilitative Services
DDD: Division of Developmental Disabilities
DES: Department of Economic Security
EPSDT: Early and Periodic Screening, Diagnosis, and Treatment
HIPAA: Health Insurance Portability and Accountability Act
NARBHA: Northern Arizona Regional Behavioral Health Authority
PCP: Primary Care Provider
PPC: Prior Period Coverage – member was or is in a transitional period with regard to coverage while AHCCCS completes the enrollment process
QMB: Qualified Medicare Beneficiary
RBHA: Regional Behavioral Health Authority
SOBRA: Sixth Omnibus Budget Health Authority
WIC: Women, Infants, and Children (nutritional program)

Appeal – A formal complaint made where a member is not satisfied with a decision made by our plan.
Behavioral Health Crisis – A situation where, without immediate help, you might hurt yourself or someone else.
Behavioral Health Services – Services that help with mental health, emotional health, or substance use concerns. These services may include counseling, therapy, and crisis support.
Co-payment – A small charge or fee due at the time covered services are provided.
Emergency – A situation where a person’s health, or the health of an unborn baby, could be threatened. Medical help is needed right away.
Grievance – A member’s expression of dissatisfaction with any part of their care. A grievance can be filed over the phone or in writing.
Health Care Power of Attorney – A person you choose to make health care decisions for you if you cannot make them yourself.
High-risk pregnancy – A pregnancy for which the mother or baby may be at higher risk for illness or death.
Living Will – A document where you write what you want done with your health care. The doctor uses this if you are not able to express what you want. It lists specific treatments you do or do not want. It can also tell your doctor whether or not to make special efforts to save your life.
Mammogram – Screening exam for breast cancer. Recommended for women over the age of 35.
Managed Care – A health plan that helps coordinate your health care services through a network of doctors and other providers.
Maternity care – Includes medically necessary pregnancy counseling, pregnancy testing, prenatal care, labor and delivery services, as well as care after delivery.
Maternity care coordination – Services that help make sure a pregnant member receives the care and support needed during and after pregnancy.
Medical Necessity – Health care services or supplies needed to prevent, diagnose, or treat a medical condition.
Member – An eligible person enrolled in Blue Cross Blue Shield of Arizona Health Choice.
Personal Health Information (PHI) – Information about your health, the care you receive, or payments for your health care services.
Postpartum care – Health care provided to the mother for up to 60 days after delivery.
Practitioner – Generally, refers to a certified nurse practitioner, midwife, or physician assistant.
Prenatal care – Health care provided during the pregnancy.
Prescription – A doctor’s written instructions for medication or treatment.
Primary Care Physician (PCP) – The doctor, nurse practitioner, physician assistant, or other provider who helps manage your health care.
Prior Authorization – Approval that may be needed from your health plan before you receive certain services or treatments.
Provider – A doctor, hospital, clinic, pharmacy, therapist, or other health care professional or facility that provides care.
Referral – Permission from your primary care provider to receive certain services or see a specialist.
Seriously and Persistently Mentally Ill (SPMI) – A serious mental health condition that can make everyday activities difficult.
Special Health Care Needs – Ongoing physical, developmental, behavioral, or emotional conditions that require extra health care services or support.
Specialist – Any doctor who has special training for a specific condition or illness.
Urgent Care – Care provided to patients when their condition is not life threatening, but cannot wait until the next business day for treatment.
Women, Infants and Children (WIC) – A community program that provides food, nutrition counseling and access to health services to low income women, infants and children.