Primary Care Physicians (PCPs) or Primary Care Doctors
Doctors provide a range of health care services for a patient, such as treating minor illnesses, performing routine health tests, providing referrals, keeping patients’ medical records, etc. Usually PCPs are the first contact for patients.
Specialist
A physician specialist focuses on a specific area of medicine or a group of patients to diagnose, manage, prevent, or treat certain types of symptoms and conditions, such as allergists, dermatologists, gastroenterologists, etc.
Referral
A note or call from a doctor to see another health care provider, usually a specialist. Depending on your insurance plan, you may need a referral to see a specialist. If students have the SHIP through Rutgers, they do not need a referral to see a specialist.
In-Network
Doctors, hospitals, and other providers that have agreed to provide health care services to the health plan at set rates. We recommend using in-network provides since patients will typically pay less with in-network providers.
Out-of-Network
Services provided by a non-participating provider. Out-of-Network providers usually cost more than in-network providers.
Co-Payment or Co-Pay
A fixed amount (for example, $25 for a primary care visit) you pay for a covered health care service, usually when you receive the service. The amount can vary by the type of covered health care service.
Co-Insurance
Your share of the costs of a covered health care service, calculated as a percent (for example, 20%) of the allowed amount for the service. You pay co-insurance plus any deductibles you owe. For example, if the health insurance’s or plan’s allowed amount for an office visit is $100 and you have met your deductible, your co-insurance payment of 20% would be $20. The health insurance or plan pays the rest of the allowed amount.
HIPAA
The Health Insurance Portability and Accountability Act (HIPAA) is a federal law that required the creation of national standards to protect sensitive patient health information from being disclosed without the patient’s consent or knowledge. Under HIPAA, students’ health records cannot be released to anyone, including parents, without their written consent.
FERPA
The Family Educational Rights and Privacy Act (FERPA) is a U.S. Federal Law that protects the privacy of student education records. After a student reaches the age of 18, student educational records are considered confidential and may not be released without the written consent of the student. Under FERPA, Rutgers cannot share with you or any family member information about your student without their consent. For more information, please click here.
For additional information on healthcare terminology, please click here.
