Find a Doctor glossary

Accepting new patients - This doctor/health care provider accepts both new patients and current patients who change from other health plans to Priority Health. We collect this information when they join our network. They are required to give us 60 days' notice when changing from accepting new patients to not accepting new patients. We rely on them to keep us informed of their status, so this information is not verified independently.

Accreditation/certification - A review process that hospitals and other health care facilities go through voluntarily to identify and correct problems and improve the safety and quality of the care and services they provide. Several different agencies set these standards and offer accreditation/certification programs. We collect information on a hospital or other facility's accreditation/certification when it joins our network and every 3 years afterward. We verify the information each time, either by contacting the accrediting/certifying agency directly or through a copy of the approval letter or report provided by the facility.

Adolescent immunizations - We measure the percentage of this practice group's Priority Health patients who received a complete vaccine series by their 13th birthdays.

Asthma care - We measure the percentage of this practice group's Priority Health asthma patients who were prescribed long-term asthma control medications according to recommended guidelines. Long-term control medications help reduce the inflammation that causes asthma attacks.

Blood pressure control - We measure the percentage of this practice group's Priority Health patients with high blood pressure whose most recent blood pressure was less than or equal to 140/90. Managing blood pressure helps prevent other health problems.

Board certification -

Certified: A doctor who is board-certified has:
  • Received training from an approved residency program
  • Voluntarily taken and passed a comprehensive test of his or her knowledge in a specialty
  • Met the other requirements set by the board that gives the test
Eligible: a doctor who is board-eligible has:
  • Completed an approved residency
  • Qualified to take a comprehensive test to become board-certified, but has not yet taken it
No certification: a doctor who is not board certified or board-eligible

Not applicable: board certification is not available to this type of provider.

We collect board certification information when a doctor joins our network, and every 3 years afterward. Each time, we verify this information with a primary source.
  • You can check the most current board certification status at the American Board of Medical Specialties website, www.abms.org. The service is free, but you will have to register and log in.
  • You can also check current board certification status for most DO physicians for free at www.osteopathic.org.

Body Mass Index measurement - We measure the percentage of this practice group's Priority Health patients who had their BMI calculated and recorded during an office visit during the year. BMI can identify patients who are overweight or obese, which increases the risk of many diseases and health conditions including diabetes, heart disease and stroke.

Bronchitis treatment - We measure the percentage of this practice group's Priority Health bronchitis patients who weren't prescribed antibiotics. Antibiotics don't usually help bronchitis, and overuse of antibiotics can cause long-term antibiotic resistance.

Breast cancer screening - We measure the percentage of this practice group's female Priority Health patients ages 40-69 who have had mammograms within the past two years. Mammography screening can find breast cancer early.

Cervical cancer screening - We measure the percentage of this practice group's female Priority Health patients ages 21-64 who had Pap tests within the past three years. Pap tests can find cervical cancer early.

Childhood immunizations - We measure the percentage of this practice group's Priority Health patients who received complete vaccine series by their second birthdays. Immunizations can prevent serious childhood illnesses.

Chlamydia screening - We measure the percentage of this practice group 's Priority Health sexually active female patients ages 16-25 who had a chlamydia test during the year. Early detection and treatment of chlamydia can prevent pelvic inflammatory disease and sterility.

Cholesterol control - We measure the percentage of Priority Health adult patients of this provider's practice group with a cardiovascular condition whose most recent LDL screening was less than 100 mg/dL.

Colorectal cancer screening - We measure the percentage of this practice group's Priority Health patients ages 50-75 who have had an appropriate screening for colorectal cancer. Early detection and treatment can help prevent cancer from developing.

Depression screening - We measure the percentage of this practice group's Priority Health patients ages 12 years and older who had an appropriate screening for depression. Early detection and treatment can help with management of this potentially debilitating condition.

Diabetes care - We measure the average performance of this practice group in managing HbA1c results and LDL-C levels, documenting retinal eye exams, screening for nephropathy and controlling blood pressure in Priority Health patients with diabetes. Actively managing diabetes leads to fewer health problems associated with diabetes.

Disease management - Patients who have chronic (long-term) diseases such as diabetes, asthma and depression can live a higher quality life and be more productive at work when they actively manage their diseases. Management includes seeing a doctor regularly, taking prescribed medications as ordered, and getting laboratory tests as ordered. Only primary care providers (PCPs) who have 100 or more Priority Health patients are eligible to be measured in the disease management category. Providers are measured as a practice group (all participating doctors in one office receive the same rating).

Facility - The name of the hospital, care center or other building name provided to us by the health care provider. We do not verify this information.

Fellowship - A doctor who has finished medical school, residency and who is training for a very specialized area of medicine.

Gender - The information on whether a person is male or female is provided by health care providers when they apply to participate in our networks. We do not verify this information.

Hospital affiliation - All hospitals where the doctor or other health care provider has affiliations. The primary hospital affiliation (indicated by the *) is the hospital where a doctor will usually admit a patient or send a patient for services. We collect this information from them when they join the network and again at least every 3 years; these affiliations are self-reported and not otherwise verified.

Internship - A one-year period of training immediately following medical school.

Kidney disease screening - We measure the percentage of this practice group's Priority Health adult patients with a diagnosis of diabetes or high blood pressure who were screened for kidney disease.

Medicare participant - Doctors who accept Medicare payment will see patients who have Medicare coverage. This is important because patients with Medicare coverage may pay more to see doctors who do not participate with Medicare.

Medication monitoring - We measure how many of this practice group's patients are on long-term medications, and what percentage of those got annual lab tests to monitor the effects of the medications. Medications included angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARB), digoxin, diuretics and anticonvulsants.

Medication e-prescribing - Measures the percentage of this practice's prescriptions that were sent to pharmacies electronically.

Office: The address provided by the health care provider or facility. We do not verify this information.

Other medical interests - Other areas of medicine that the doctor or other health care provider has interest and/or knowledge. This information is volunteered to us, and not all treatments listed under "Medical Interests" are covered benefits by Priority Health. Refer to your coverage documents for specific benefit information.

Overall quality - This score (1 to 4 apples) is based on combining all the weighted scores of all quality measures except e-prescribing into a single number.

PCP/provider speaks - Lists languages other than English that this health care provider may speak. We collect this information when providers join our network and then every 3 years afterward, but we don't research or verify what they report. It's important for patients and their doctors and other health care providers to understand each other for optimal treatment. Interpreters can help when language barriers come between providers and their patients.

POS A, POS B - These are two slightly different versions of the PriorityPOSSM health plan. POS A refers to the network used by the traditional fully funded point-of-service (POS) plan, where for a set premium per member, Priority Health covers both the administrative and the medical costs of all members. POS B refers to the network used by the self-funded and shared funded versions of the POS plan, where the members' employer covers all or part of the medical costs. Members can contact their employer or Priority Health Customer Service (800 446-5674) to find out whether their plan is POS A or POS B.

Practice group - A group of doctors and/or other health care providers who practice together, generally out of the same location.

Practice name - The business name used by a doctor or health care provider, or by a group of health care providers. Some large practices have many practice groups in different locations, all sharing one practice name. Doctors and other providers give us their practice names when they join our network, and every 3 years afterward. We do not do other verification of this information.

Preventive health - Regular preventive care can keep you from getting sick or help you and your doctor spot illnesses early so that they can be more easily treated. Examples of preventive care include immunizations and cancer screenings. Only primary care providers (PCPs) with 100 or more Priority Health patients are eligible for measurement in preventive health.

Professional degrees:

ACSW: Academy of Certified Social Workers - A certified social worker meeting specific requirements in supervised social work experience and reference ratings. Also has passed the ACSW written examination. Note: Not all eligible social workers voluntarily achieve this designation.
CNM: Certified Nurse Midwife - A registered nurse who has received additional training as a midwife, delivers infants, and provides antepartum and postpartum care
CSW: Certified Social Worker - An individual registered as a Certified Social Worker with the State of Michigan Department of Consumer & Industry Services.
DC: Doctor of Chiropractic - a specialist licensed in a system of therapy which holds that disease results from a lack of normal nerve function and which employs manipulation and specific adjustment of body structures (as the spinal column).
DDS: Doctor of Dental Surgery - A specialist licensed in dentistry.
DMD: Doctor of Dental Medicine - A specialist licensed in dentistry.
DO: Doctor of Osteopathic Medicine - The degree a person receives after completing four years of medical school. A doctor of osteopathic medicine is licensed in the system of medical practice based on a theory that diseases are due chiefly to loss of structural integrity, which can be restored by manipulation of the parts supplemented by therapeutic measures (as in the use of medicine or surgery). After completion of medical school, a doctor of osteopathic medicine chooses an area of medicine to specialize in a residency.
DPM: Doctor of Podiatric Medicine - A specialist licensed in the medical care and treatment of the human foot.
Ed.D.: Doctor of Education - The degree a person receives after completing a four-year post-graduate program specific to their field. For example, psychology.
LLP: Limited Licensed Psychologist - An individual issued a limited license by the State of Michigan Department of Consumer & Industry Services to practice psychology. A person with this license practices under the supervision of a licensed psychologist.
LMSW: Licensed Master of Social Work - The degree and license a person receives after completing a graduate-level program in social work.
LPC: Licensed Professional Counselor - An individual issued a license by the State of Michigan Department of Consumer & Industry Services to practice counseling.
MA: Master of Arts - The degree a person receives after completing a graduate-level program specific to their field. For example, counseling or psychology.
MD: Medical Doctor - The degree a person receives after completing four years of medical school. A medical doctor is licensed in the science and art of dealing with the maintenance of health and the prevention, alleviation, or cure of disease. After completion of medical school, a medical doctor chooses an area of medicine to specialize in and completes a residency.
MS: Master of Science - The degree a person receives after completing a graduate-level program specific to their field. For example, counseling or psychology.
NP: Nurse Practitioner - A registered nurse who through advanced training is qualified to assume some of the duties and responsibilities formerly assumed only by a physician.
OD: Doctor of Optometry - A specialist licensed to practice the art or profession of examining the eye for defects and faults of refraction and prescribing especially corrective lenses or exercises.
PA, PA-C: Physician Assistant, Physician Assistant - Certified - A specially trained person who is certified to provide basic medical services (as the diagnosis and treatment of common ailments) usually under the supervision of a licensed physician.
Ph.D.: Doctor of Philosophy - The degree a person receives after completing a four-year post-graduate program specific to their field. For example, clinical psychology.
Psy.D.: Doctor of Psychology - The degree a person receives after completing a four-year post-graduate program in psychology.

Residency - A period of advanced medical training and education that normally follows graduation from medical school and licensing to practice medicine and that consists of supervised practice of a specialty in a hospital and in its outpatient department and instruction from specialists on the hospital staff.

School - The school where the practitioner attended before post-graduate education and before starting to practice medicine. For doctors, this would be their Medical School.

Self-funded - A plan set up so the employer pays all employee health care costs directly. Priority Health manages these plans but does not fund them.

Specialty - The specific area of medicine in which a practitioner has been trained. We collect specialty information when practitioners join our network and verify their training with a primary source. This information is not verified again unless the practitioner requests a change in specialty.

Staff speaks - Lists languages that someone who works at the same office, practice or facility may speak. We collect this information from health care providers when they join our network and then every 3 years afterward, but we don't research or verify what they report.

Supervising physician - A physician who supervises resident physicians. If you choose this practitioner, it is highly likely that a resident in training will take care of your health care needs. When choosing an attending physician as your PCP, his/her name will appear on your member ID card. If you get a referral to a specialist, it is highly likely that a resident will provide your specialty care. To understand the benefits of choosing a residency training program for your health care needs, please feel free to call the number listed for the attending or supervising physician.

Well-child visits - We measure the percentage of this practice group's Priority Health pediatric patients who had annual preventive health exams.