- 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 communication system that enables a member to request specified documents or forms by entering information on the telephone keypad and to receive the requested information by fax.
Industry:Health care
An agreement with a provider not to bill the subscriber for any difference between billed charges for covered services (excluding coinsurance) and the amount the provider has contractually agreed with a BCBS Plan as full payment for those services.
Industry:Health care
The risk evaluation an MCO performs when it first issues coverage to a group.
Industry:Health care
A voluntary health insurance program for federal employees, retirees, and their dependents and survivors.
Industry:Health care
An individual or organization that offers care to patients from outside the local Plan's service area. Services may be provided from a single site or from multiple locations. The provider of service is the one who files a claim for a service supplied to the member. BlueCard applies if the provider of service is outside the member's Blue Plan's service area and does not contract with the member's Plan. The member's location at the time of service is irrelevant. Often the patient and the indirect care provider are in different physical locations.
Industry:Health care
A provider contract clause which states that the provider agrees to accept the amount the plan pays for medical services as payment in full and not to bill plan members for additional amounts (except for co-payments, coinsurance, and deductibles).
Industry:Health care
A federal act which established the Federal Trade Commission (FTC) and gave the FTC power to work with the Department of Justice to enforce the Clayton Act. The primary function of the FTC is to regulate unfair competition and deceptive business practices, which are presented broadly in the Act. As a result, the FTC also pursues violators of the Sherman Antitrust Act. See also antitrust laws.
Industry:Health care
Employer group that has offices or branches in more than one location, but offers uniform coverage of benefits to all of its employees.
Industry:Health care
The MCO committee that recommends nominations for company officers as required in the organization's bylaws.
Industry:Health care
