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Glossary

Healthcare and health insurance definitions.

A B C D E F G H I L M N O P Q R S T U V W

R

Referral :

A process by which a member’s primary care practitioner (PCP) directs them to other providers, usually specialists, for further care. Some health plans require you to get a formal referral from your PCP before you see a specialist or other type of provider. (Please note, a doctor suggesting the names of other providers is not the same thing as a formal (usually written) referral.)

Referral authorization :

The processes an insurance company uses for reviewing and authorizing referrals to specialist physicians or other types of providers by primary care practitioners.

Rehabilitation services :

Services designed to help you maintain, regain, or improve everyday skills affected by an illness or injury. See ACA Uniform Glossary

Rider :

A rider is an amendment to an insurance policy. Some riders will add coverage (such as adding a dental rider to a medical policy), while some riders exclude coverage for a certain service or condition.