- 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.
The actual cost of providing healthcare to a group during a given period of coverage.
Industry:Health care
Blue Cross and Blue Shield Association's Web site, which contains useful information for providers.
Industry:Health care
A salesperson who has obtained a state licence to sell and service contracts of multiple health plans or insurers, and who is ordinarily considered to be an agent of the buyer, not the health plan or insurer.
Industry:Health care
A rating method under which an MCO analyses a group's recorded healthcare costs by type and calculates the group's premium partly or completely according to the group's experience.
Industry:Health care
A provision in a member's coverage that limits the amount of coverage by the plan to a certain percentage, commonly 80 percent. Any additional costs are paid by the member out of pocket.
Industry:Health care
A process that includes creating a financial plan of action that an organisation believes will help it to achieve its goals, given the organization's forecast.
Industry:Health care
An illegal business practise that occurs when two or more independent competitors agree on the prices or fees that they will charge for services.
Industry:Health care
A utilisation review resource that recognises generally accepted community standards of practise and the overall experience and expert opinion of medical directors and other healthcare providers.
Industry:Health care
Ensures that people receive full benefits and prevents double payment for services when a member has coverage from two or more sources. The language gives the order for what insurance organisation has primary responsibility for payment and what insurance organisation has secondary responsibility for payment.
Industry:Health care
The unification of one or more separate business (nonclinical) functions into a single function.
Industry:Health care
