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Exam (elaborations)

BlueCross BlueShield Updated 2024/2025 Verified 100%

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What title is listed on the BlueCross BlueShield identification cards for federal employees? - Government-Wide Service Benefit Plan The retrospective review process associated with a utilization management program - reviews medical necessity and appropriateness of medical procedures and services...

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  • August 26, 2024
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  • 2024/2025
  • Exam (elaborations)
  • Questions & answers
  • BlueCross BlueShield
  • BlueCross BlueShield
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ACADEMICMATERIALS
BlueCross BlueShield
What title is listed on the BlueCross BlueShield identification cards for federal employees? -
Government-Wide Service Benefit Plan



The retrospective review process associated with a utilization management program - reviews
medical necessity and appropriateness of medical procedures and services provided as part of claims
processing



Prior to the joint venture between BlueCross and BlueShield, the BlueShield plans covered only -
physician services



BlueCross facilities that had signed contracts to provide services to subscribers for special rates were
known as _____ hospitals. - member



In what year was the BlueCross BlueShield Association (BCBSA) created? - 1986



Which is function of the BlueCross BlueShield Association (BCBSA)? - owning BCBS trademarks



The difference between for-profit status and nonprofit status is that - for-profit corporations pay
taxes on profits generated by the corporation



The pre admission review component of a utilization management plan - evaluates medical
necessity and required level of care for inpatient procedures, services, and elective admissions




An example of a benefit provided by BlueCross BlueShield basic coverage is _____ health care. -
mental



The outpatient pretreatment authorization plan (OPAP) is also known as - precertification

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