- 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 development and implementation of parameters for the delivery of health-care services to plan members.
Industry:Health care
A situation in which the state insurance commissioner, acting for a state court, takes control of and administers an HMO's assets and liabilities.
Industry:Health care
A healthcare system that assumes or shares both the financial risks and the delivery risks associated with providing comprehensive medical services to a voluntarily enrolled population in a particular geographic area, usually in return for a fixed, prepaid fee.
Industry:Health care
A type of outcomes measure that relates to biological health outcomes.
Industry:Health care
An MCO's periodic review of the qualifications of a current network provider to verify that the provider still meets the standards for participation in the network.
Industry:Health care
Preventive care programs designed to educate and motivate members to prevent illness and injury and to promote good health through lifestyle choices, such as smoking cessation and dietary changes. Also known as wellness programs.
Industry:Health care
A provision which specifies that plan members must obtain medical services only from network providers through a primary care physician to receive benefits.
Industry:Health care
The provision that only those drugs on a preferred list will be covered by a PBM or MCO.6
Industry:Health care
