- 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 hiring of external vendors to perform specified functions, such as data and information management activities, for an MCO.
Industry:Health care
A contract under which a third party administrator or an insurer agrees to provide administrative services to an employer in exchange for a fixed fee per employee.
Industry:Health care
A situation in which an MCO's operations are placed under the direction and control of the state commissioner of insurance or a person appointed by the commissioner.
Industry:Health care
A type of outcomes measure related to whether the patient feels completely "better" after treatment or feels improved compared to how he or she felt prior to receiving treatment.
Industry:Health care
Any harm a patient suffers that is caused by factors other than the patient's underlying condition.
Industry:Health care
A system in which the appropriateness of healthcare services delivered by a provider to health plan members is evaluated by a panel of medical professionals.
Industry:Health care
The MCO committee that reviews cases of healthcare services delivery in which the quality of care is questionable or problematic.
Industry:Health care
A person who is authorized by an MCO or an insurer to act on its behalf to negotiate, sell, and service managed care contracts.
Industry:Health care
