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Types of Providers

Types of Providers

If you have complicated health issues or your doctor has called another doctor an industry term you’ve never heard before, you may be left wondering what all these health care names really mean. We can help you make sense of the different types of providers.

Your Doctors

Primary Care Provider (PCP)

A primary care provider, or PCP, is your main doctor. It’s who you visit for routine checkups, preventive care, and general health problems. Each person in your family can have a PCP, or you can all see the same one.

If you’re on an HMO or POS plan, you have to choose an in-network PCP who will oversee your care and refer you to specialists. If you’re on a PPO plan, you don’t have to choose a PCP to get referrals, but you can to get personalized care and savings.

And if you’re a woman, you can set a doctor as your PCP or choose another in-network doctor, like an OB-GYN, to oversee free preventive care, your yearly well-woman visit, or a pregnancy.

Setting and changing your PCP is easy. Just log in to Your Health Alliance to update your PCP.

Specialist

A specialist is a doctor who provides health care services for a specific disease or part of the body, like dermatologists, who focus on skin care.

Usually, you’ll be referred to a specialist when your personal doctor wants you to check on specific issues or problems. You’ll also be sent to a specialist when you’re diagnosed with something serious, like a heart condition or cancer, or if you find out you’re pregnant. 

Surgeon 

A surgeon is a doctor who is qualified to perform surgery, and they have their own specialties. If you have a heart attack and need surgery, your surgeon will be an expert in heart surgery.

If you’re sent to the ER because of an emergency or diagnosed with a condition or disease, you might be sent into surgery. But if you need a minor procedure, like having your wisdom teeth out, you’re seeing a surgeon too. 

Hospitalist

A hospitalist is a dedicated, in-patient doctor who works only in a hospital or network of hospitals. If you’re taken to the hospital in an emergency or accident, you might be treated by a hospitalist.

Help with Your Care

Care Coordinator

Care coordinators help you figure out your health care in lots of ways, especially after a hospital stay, diagnosis, or if you have a chronic or complex condition.

They can help provide you with resources, educational materials, and self-care techniques, help you understand your doctor’s instructions, connect you to resources in your community, and help you plan for the future.

Health Coach

Health coaches can help you or your family plan for better health. Our health coaches can help you get the best care possible from your healthcare team and get the most from your coverage.

They’ll partner with you to help in areas like nutrition, weight and stress management, and preventive screenings and immunizations.

Nurse Navigators

You might get help handling your care from a nurse navigator when you’re discharged from the hospital if you get a serious diagnosis. For example, a cardiac nurse navigator will help patients with a primary diagnosis of heart failure or myocardial infarction.

They will usually start the process by visiting you before you leave the hospital, then they’ll stay in-touch to walk you through the first 30 days after discharge. 

Nurse navigators can help you organize your appointments, connect you to education on your diagnosis, medications, exercise, diet, therapies, and when to call the doctor. And they might host support groups that can help people like you.

Other Kinds of Care

Home Health Care

Home health care is medical care, treatment, or skilled care you can get in your home. You doctor might recommend this in situations where care in your own home will be easier for your case and condition.

Skilled Nursing Facility

You doctor might order medical care that must be given or supervised by a licensed health care professional in a skilled nursing facility. This type of care could include:

  • X-rays and other radiology services
  • Physical, occupational, and speech therapy
  • Storage and administration of blood
  • Use of appliances, like wheelchairs
  • Meals, including special diets
  • A semiprivate room or private room if medically necessary

Hospice Care

Hospice care is special care for people who are terminally ill, including medical and physical care and help with social, emotional, and spiritual needs. It also provides support for family and caregivers.

Other Help

Pharmacist

Pharmacists are healthcare professionals who practice pharmacy, which focuses on safe and effective medication use. You might not think about your pharmacist’s skillset when you pick up your drugs at the pharmacy, but they’re trained to know how drugs work.

They know which drugs can interact to protect you from dangerous drug combinations, they can explain the side effects of your drug to you, and they make sure you’re getting the right dosage of your drugs on the right schedule.

Social Worker

Social workers are there to help you with social problems that can affect your quality of life and health care. They can help you and connect you to resources for domestic violence, sexual assault, abuse and neglect, housing and food insecurity, home-delivered meals, substance abuse, mental health issues, advance directives, and more.

Other Providers

Medical Director

A medical director is a leader who recruits and manages doctors, nurses, and other personnel. They also examine and coordinate processes within their organizations to improve and guarantee the medical quality of the facility. 

If you need to find covered providers, use our Find a Doctor or Hospital tool to search for covered doctors, hospitals, and more.

Knit with Heart

Vantage Point: Seniors Knit with Love to Help Others

Before I met with Aїda Bound—a social worker and fierce fighter for civil rights, social justice, the aged, and the underserved—I hoped to impress her with the yarn I was going to donate to the greater Wenatchee Area Hat Project. But as Aїda talked about collecting, sorting, storing, and delivering the hats and the difference the program makes to the (mostly) seniors who make the hats and the children in need who receive them, I was the one who was dazzled.

Health Alliance Medicare employees get the chance to help members every day by giving them great customer service and healthcare benefits. Having a local presence means we can also be involved in North Central Washington communities. Helping others is the principle behind the Hat Project, too. Seniors can join in, even if they are homebound with poor health. Yarn is donated, and hat makers get to choose the design, color, and pattern of each hat and can knit, crochet, or use a loom.

The hat makers know their time and talents are helping others, and it gives them a chance to be creative and social while having fun. One 98-year-old member said it gave her a reason to live. Aїda helped a woman who had dementia and couldn’t remember the pattern keep participating by having her tie knots for quilts made by another member. That way the woman could still benefit from the social support the program provides.

Aїda said, “Love is knitted into each hat and is what makes the difference to the children.” For some kids, choosing a handmade hat may be the first time they have ever been able to pick out something brand-new for themselves.

To donate to the Wenatchee Area Hat Project, please drop off yarn at Wenatchee and East Wenatchee Washington Trust Banks. (They welcome gas card donations, too.)

As someone who donated yarn, it was fun to choose the colors and imagine a senior making something so beautiful for a child in need. If you think a Hat Project could benefit your community, Aїda is willing to help. Call her at 509-888-1953, or email her at gutsgranny@nwi.net.

 

Shannon Sims is a Medicare community liaison for Health Alliance, serving Chelan, Douglas, Grant, and Okanogan counties in Washington. She has four adult sons and two grandsons. During her time off, she performs as part of a rodeo drill team on her horse, Skeeter.