- 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.
An organization that uses an HMO model to provide healthcare services in a subset or single specialty of medical care.
Industry:Health care
The combination of systems, processes, and technology that an MCO uses to provide the company's information users with the information they need to carry out their job responsibilities.
Industry:Health care
An organization that is recognized by the authority of a governmental unit as a legal entity separate from its owners.
Industry:Health care
Healthcare services that are generally considered outside standard medical-surgical services because of the specialized knowledge required for service delivery and management.
Industry:Health care
An interactive combination of people, computer hardware and software, communications devices, and procedures designed to provide a continuous flow of information to the people who need information to make decisions or perform activities.
Industry:Health care
The practice of charging more for services provided to paying patients or third-party payers to compensate for lost revenue resulting from services provided free or at a significantly reduced cost to other patients.
Industry:Health care
The wide range of electronic devices and tools used to acquire, record, store, transfer, or transform data or information.
Industry:Health care
The review and verification process used to determine the current clinical competence of a provider and whether the provider meets the MCO's pre-established criteria for participation in the network.
Industry:Health care
Ratios that relate the number of providers in the network to the number of enrollees in the health plan.
Industry:Health care
