- 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 process of identifying plan members with special healthcare needs, developing a health-care strategy that meets those needs, and coordinating and monitoring care.
Industry:Health care
The Medicare+Choice delivery option under which coverage is provided by private insurance carriers rather than through the federal government.
Industry:Health care
Healthcare quality indicators related to the methods and procedures that an MCO and its providers use to furnish service and care.
Industry:Health care
The fee determined by an MCO to be acceptable for a procedure or service, which the physician agrees to accept as payment in full. Also known as a fee allowance, fee maximum, or capped fee.
Industry:Health care
Under initial Medicaid eligibility requirements, individuals who received Medicaid benefits because of their welfare status.
Industry:Health care
A set of characteristics or behaviors that are worthy of the high standards of an occupation that requires advanced training in a specialized field.
Industry:Health care
A benefit payment system in which an insurer reimburses the group member or pays the provider directly for each covered medical expense after the expense has been incurred.
Industry:Health care
