Glossary of Terms

Participating Provider
A hospital or practitioner who signs a contract and completes credentialing with a managed care plan and agrees to care for plan members for negotiated fees and conditions specified in the contract. Typically, when plan members see participating providers, they have low co-payments and no paperwork to file with the plan. To become a participating provider, a provider must be a contracted provider and fully credentialed.
Patient-centered Medical Homes (PCMH)
A model of care where each patient has an ongoing relationship with a personal physician who leads a team that takes collective responsibility for patient care.
Peer Specialist
Individuals who hold a credential from a certifying authority recognized by the commissioner of OASAS or OMH. Peer specialists are supervised by a credentialed or licensed clinical staff member to provide peer support services or other authorized services based on clinical need as identified in patients' treatment/recovery plans.
Per Member Per Month (PMPM)
The amount a provider receives per month for each patient he or she is treating. Also known as capitation payment.
Performance Improvement Project (PIP)
A concentrated effort on a particular problem in one area of the facility or facility wide; it involves gathering information systematically to clarify issues or problems, and intervening for improvements.
Performing Provider System - DSRIP (PPS)
An entity responsible for performing a DSRIP project, requires collaboration between a number of hospitals and/or agencies.
Personalized Recovery Oriented Services (PROS)
A comprehensive recovery oriented program model that integrates rehabilitation, treatment, and support services for people with serious mental illness.
Primary Care Provider (PCP)
The health care professional mainly responsible for the care of a patient, especially in an outpatient setting.
Primary/Behavioral Health Care Integration (PBHCI)
A SAMHSA program that supports communities coordinating and integrating primary care services into publicly funded, community-based behavioral health settings with the goal of improving access to primary care; prevention, early identification, and intervention efforts; integrated holistic care; and overall health status of patients.
Prospective Payment System (PPS)
A method of reimbursement in which Medicare payment is made based on a predetermined, fixed amount. The payment amount for a particular service is derived based on the classification system of that service (for example, diagnosis-related groups for inpatient hospital services).
Psychiatric Advance Directive
A legal document giving instructions for future mental health treatment or appointing an agent to make future decisions about mental health treatment. The document is used when the person who created the document experiences acute episodes of psychiatric illness and becomes unable to make or communicate decisions about treatment.