- 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.
A type of managed care specialty service organisation that seeks to contain the costs of prescription drugs or pharmaceuticals while promoting more efficient and safer drug use. Also known as a prescription benefit management plan.
Industry:Health care
The computer-to-computer transfer of data between organisations using a data format agreed upon by the sending and receiving parties.
Industry:Health care
The amount commonly charged for a particular medical service by physicians within a particular geographic region. UCR fees are used by traditional health insurance companies as the basis for physician reimbursement.
Industry:Health care
The MCO committee that reviews member appeals related to medical management or coverage determinations.
Industry:Health care
A company, owned by a group of investors, that purchases physicians' practise assets, provides practise management services, and, in most cases, gives physicians a long-term contract to continue working in their practise and sometimes an equity (ownership) position in the company.
Industry:Health care
A computerised record of a patient's clinical, demographic, and administrative data. Also known as a computer-based patient record.
Industry:Health care
A utilisation review resource that indicates accepted approaches to care for common, uncomplicated healthcare services.
Industry:Health care
A process in which the parties to a dispute submit their dispute to an impartial third party for a final, binding decision.
Industry:Health care
A joint venture between a hospital and many or all of its admitting physicians whose primary purpose is contract negotiations with MCOs and marketing.
Industry:Health care
A specialist in employee benefits and insurance who is hired by a group buyer to provide advice on a health plan purchase.
Industry:Health care
