Dartmouth Atlas of Health Care in Michigan
An extensive study of medical care in Michigan, The Dartmouth Atlas uses Blues’ claims data and other information to analyze the use and supply of health care services.
The dollar amount members must pay the provider for covered services before Blues’ payments begin.
A funding mechanism for health care, with the group making a specific dollar contribution toward the cost of insurance coverage for its members without specifying benefits to be covered.
The preferred term for a hospital that performs its own admission precertifications, meeting BCBSM requirements.
A computer application designed for medical offices, the Dial-In Eligibility Network and Information System provides immediate information about a Blues member, including eligibility, benefits and claims for professional services.
A DDS (doctor of dental surgery) or DMD (doctor of dental medicine) who is licensed by the state to diagnose and treat the human tooth, the alveolar process, and gums and jaws or their dependent tissues. See also oral and maxillofacial surgeon.
A rider for the continued coverage of children between 19 and 25 years who meet certain conditions.
See delegated facility.
diagnosis related group
diagnostic coding system
The process that helps patients and their families arrange for follow-up care — from medical equipment to in-home care services — that will be needed after the patient leaves the hospital.
Programs designed to help members manage chronic conditions through a partnership between members, physicians and the health plan. Disease management programs focus on member education and self-management strategies in an effort to reduce costs and improve quality.
dispense as written
Physician’s DAW instructions on a prescription specify a brand-name pharmaceutical or medical device.
See durable medical equipment.
doctor of chiropractic
A practitioner of a science of applied neurophysiologic diagnosis based on the theory that health and disease are life processes related to the function of the nervous system.
doctor of medicine
A practitioner who has received a degree from a college of medicine and has been licensed by the appropriate board for the diagnosis and treatment of a human physical or mental condition.
doctor of osteopathy
A practitioner who is a graduate of an accredited school of osteopathic medicine that emphasizes the need for the body’s systems to be in correct relationship with one another and the importance of the musculoskeletal system.
doctor of podiatry
A specialist who deals with the care of the foot, including its anatomy, pathology, medical and surgical treatment.
See custodial care.
A reimbursement system, the diagnostic related group classifies patients according to the severity of their illnesses and the resources needed to treat them.
durable medical equipment
Medically necessary equipment that can be used repeatedly (for example, wheelchair or respirator) to facilitate treatment and rehabilitation at home.
Durable Power of Attorney for Health Care
A legally binding document that appoints an advocate to make medical decisions for a member who becomes unable to make them. See also advance directive.