- 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 provider contract clause which specifies a time period (usually 60-90 days) for a party that breaches the contract to remedy the problem and avoid termination of the contract.
Industry:Health care
Authoritative statements of: (1) minimum levels of acceptable performance or results, (2) excellent levels of performance or results, or (3) the range of acceptable performance or results, according to the Institute of Medicine.
Industry:Health care
The group of physicians, hospitals, and other medical care professionals that a managed care plan has contracted with to deliver medical services to its members.
Industry:Health care
A specific database (or set of databases) containing data from many sources that are linked by a common subject (e.g., a plan member).7
Industry:Health care
Long-term advisory bodies on ongoing issues such as finance management, compliance, quality management, utilisation management, strategic planning, and compensation.
Industry:Health care
A health plan manager who is responsible for developing and managing the MCO's provider networks including such activities as recruiting, credentialing, contracting, service, and performance management for providers.
Industry:Health care
A method of marketing that involves creating a database of customer information - including demographic, consumer preference, and sales history information - which is used to narrow the focus of an organization's direct marketing efforts.
Industry:Health care
A program, established by the Balanced Budget Act, designed to provide health assistance to uninsured, low-income children either through separate programmes or through expanded eligibility under state Medicaid programs.
Industry:Health care
The risk evaluation an MCO performs when it first issues coverage to a group.
Industry:Health care
A form of information technology that uses databases and decision models to enhance the decision-making process for MCO executives, managers, clinical staff, and providers.8
Industry:Health care
