- 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.
An HMO's ability to maintain at least the minimum amount of capital and surplus specified by state insurance regulators.
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 ward or section of a ward in a hospital that is devoted to delivering sub-acute care to patients following a period of acute care.
Industry:Health care
The MCO committee that recommends nominations for company officers as required in the organization's bylaws.
Industry:Health care
An organisation that provides dental services through a network of providers to its members in exchange for some form of prepayment.
Industry:Health care
A company that is owned by the people and organisations who purchase shares of the company's stock.
Industry:Health care
A market segment that consists of customers who are covered under an individual contract for health coverage or enrolled in a government program.
Industry:Health care
A dental service plan that allows a member to use either a DHMO network dentist or to seek care from a dentist not in the HMO network. Members choose in-network care or out-of-network care at the time they make their dental appointment and usually incur higher out-of-pocket costs for out-of-network care.
Industry:Health care
A type of insurance coverage that enables provider organisations or self-funded groups to place a dollar limit on their liability for paying claims and requires the insurer issuing the insurance to reimburse the insured organisation for claims paid in excess of a specified yearly maximum.
Industry:Health care
An ethical principle which, when applied to managed care, states that managed care organisations and their providers are obligated not to harm their members.18
Industry:Health care
