- 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 health plan physician executive who is responsible for the quality and cost-effectiveness of the medical care delivered by the plan's providers. Also known as a chief medical officer.
Industry:Health care
A computerized record of a patient's clinical, demographic, and administrative data. Also known as a computer-based patient record.
Industry:Health care
A utilization review resource that indicates accepted approaches to care for common, uncomplicated healthcare services.
Industry:Health care
A mistake that occurs when a planned treatment or procedure is delivered incorrectly or when a wrong treatment or procedure is delivered.
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
Managing the use of medical services to ensure that a patient receives necessary, appropriate, high-quality care in a cost-effective manner.
Industry:Health care
A not-for-profit entity, usually created by a hospital or health system, that purchases and manages physician practices.
Industry:Health care
The MCO committee that reviews and updates the MCO's utilization management program, establishes utilization review protocols, reviews referral and utilization patterns, and reviews utilization decisions for medical appropriateness.
Industry:Health care
