Glossary

N

National Provider Identifier (NPI) — 

A unique number that identifies the individual health care provider or entity.

Neonatal / Perinatal Medicine — 

A specialty focusing on the care of sick newborn infants. Specialists in this field have extensive experience derived from a focused clinical interest in the problems of newborns.

Nephrology — 

A specialty focusing on the diagnosis and management, by medication, diet or dialysis, of malfunctions and diseases of the kidney.

Network — 

A group of health care providers under contract with a managed care company, such as Horizon BCBSNJ.

Neuro Ophthalmology — 

A neuro-ophthalmologist is a doctor who specializes in visual problems that relate to the nervous system. This includes loss of sight due to injury to the brain or the optic nerves which transmits visual signals from the eyes to the brain.

Neurological Surgery — 

Neurosurgery, or neurological surgery is the medical specialty concerned with the prevention, diagnosis, surgical treatment, and rehabilitation of disorders which affect any portion of the nervous system.

Neurology — 

A specialty focusing on the diagnosis and treatment of disorders of the nervous system.

Nonparticipating Provider — 

A hospital, pharmacy, doctor or other medical service professional that does not have a contract with Horizon BCBSNJ to provide health care services to members. Depending on the member’s plan, services from a nonparticipating provider may or may not be covered. A nonparticipating provider is also referred to as an out-of-network provider. Horizon BCBSNJ Preferred Provider Organization (PPO) or Point of Service (POS) members who visit a nonparticipating provider will generally receive lesser benefits; HMO members who do so will generally not receive any benefits, except in the case of a medical emergency.

Not Covered — 

Any amount of the fee charged for the service that the health plan does not cover, or expenses that are not covered at all or that exceed your available benefits. A member may be responsible for this amount in addition to any deductible, coinsurance or copayment required by the applicable health care plan.

Nuclear Medicine — 

A branch of medicine pertaining to diagnostic, therapeutic and investigative use of radioactive chemical elements.

Nuclear Medicine Imaging — 

Uses small amounts of radioactive material, a special camera and a computer to create images of the inside of your body.

Nurse — 

A Registered Nurse (R.N) or Licensed Practical Nurse (L.P.N.), or nursing specialist, such as a nurse mid-wife or nurse anesthetist, who:

  • a) is properly licenses or certified to provide medical care under the laws of the state where he/she practices; and
  • b) provides medical services which are: (i) within the scope of his/her license of certificate; and (ii) are covered by this program.

Nurse Practitioner — 

A registered nurse who has completed an advanced training program in a medical specialty such as family practice, pediatrics or internal medicine, who:
  • a) is properly licenses or certified to provide medical care under the laws of the state where he/she practices; and
  • b) provides medical services which are: (i) within the scope of his/her license of certificate; and (ii) are covered by this program.

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