- 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 process of deciding the premium to charge for a health plan or a given set of benefits.
Industry:Health care
A knowledge-based computer system whose purpose is to provide expert consultation to information users for solving specialised and complex problems.10
Industry:Health care
A specified charge that a member must pay out-of-pocket for a specified service at the time the service is rendered.
Industry:Health care
A measure of how often members hang up before receiving assistance when they make telephone calls to a company and are put on hold.
Industry:Health care
General medical care that is provided directly to a patient without referral from another physician. It is focused on preventive care and the treatment of routine injuries and illnesses.21
Industry:Health care
Performance standards that are based on outside information such as published industry-wide averages or best practices.
Industry:Health care
A flat amount the member must pay before the insurer will make any benefit payments.
Industry:Health care
A primary care provider who contracts directly with the state to provide case management services, such as coordination and delivery of services, to Medicaid patients.
Industry:Health care
A private computer network that incorporates Web-based technologies and links selected resources of an MCO to external entities or individuals.
Industry:Health care
