If you go outside of your network the member is responsible for ______% of the payment - 100
__________________ plan are normally selected by individuals who do not have access to a group plan
or are a small business with many employees - Fee-for-service
__________ corporations are charitable, e...
BCBS
If you go outside of your network the member is responsible for ______% of the payment - 100
__________________ plan are normally selected by individuals who do not have access to a group plan
or are a small business with many employees - Fee-for-service
__________ corporations are charitable, educational, civic or humanitarian organizations whose profits
are returned to the program of the corporation rather than distributed to shareholders and officers of
the corporation - non-profit
Blue Cross Blue Shield began as two separate __________ health plans - prepaid
In ______ the membership of the separate BCBS national associations voted to combine personnel
under the leadership of a single president - 1977
In ______ BCBS merged into a single coproration - 1986
______ corporations pay taxes on profits generated by the corporations enterprises and pay dividends to
shareholders on after-tax profits - for-profit
BSBS is responsible for: - * making prompt, direct payments
* provide representatives to assist providers with claim problems/questions
* provide educational seminars, workshops
* provide billing manuals, newsletters
* publish a directory of PAR's for BCBS subscribers
PAR - Participating Provider - healthcare provider who enters into a contract with a BCBS
corporation
, BCBS programs include the following: - * Fee-for-service
* Indemnity
* Managed care plans
* Federal Employee Program
* Medicare supplemental plans
* Healthcare Anywhere
BCBS Basic coverage includes: - * Hospitalization
* Diagnostic laboratory services
* X-rays
* Surgical fees
* Assistant surgical fees
* Obstetric care
* Intensive care
* Newborn care
* Chemotherapy for cancer
Medical emergency care rider includes ________________________ - emergency services
_________________ is a healthcare delivery system that provides health care and controls costs through
a network of physicians, hospitals, and other healthcare providers - managed care
The coordinated home health and hospice care program allows patients with this option to elect an
alternative to the ____________ setting - acute care
EPO - Exclusive Provider Organization
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