- Industry: Health care
- Number of terms: 4240
- Number of blossaries: 0
- Company Profile:
The Blue Cross Blue Shield Association (BCBSA) is a federation of 39 separate health insurance organizations and companies in the United States. Combined, they directly or indirectly provide health insurance to over 100 million Americans.
Change that is deliberate, controlled, collaborative, and proactive.
Industry:Health care
A health plan's system of approving payment of benefits for services that satisfy the plan's requirements for coverage.
Industry:Health care
A healthcare option that allows members to choose at the time medical services are needed whether they will go to a provider within the plan's network or seek medical care outside the network.
Industry:Health care
A device that answers calls with a recorded message and then routes calls to the appropriate department or unit.
Industry:Health care
The practice of underwriting a number of small groups as if they constituted one large group.
Industry:Health care
An ethical principle which, when applied to managed care, states that MCOs and their providers have a duty to respect the right of their members to make decisions about the course of their lives.3
Industry:Health care
A utilization management technique that requires plan members who are scheduled for inpatient care to have preliminary tests, such as X-rays and laboratory tests, performed on an outpatient basis prior to admission.
Industry:Health care
The financial statement that shows an MCO's financial status on a specified date.
Industry:Health care
A utilization management technique that requires a plan member or the physician in charge of the member's care to notify the plan, in advance, of plans for a patient to undergo a course of care such as a hospital admission or complex diagnostic test. Also known as prior authorization.
Industry:Health care
The provision of mental health and chemical dependency (or substance abuse) services.
Industry:Health care
