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Founded in 1948, [26] Arkansas Blue Cross Blue Shield (ABCBS) [27] is an independent licensee of the Blue Cross Blue Shield Association, and the largest healthcare provider in the state. [28] It donated $1.98 million to The Walton College of Business toward founding its Robert L. Shoptaw Master of Healthcare Business Analytics Program. [ 29 ]
After a request comes in from a qualified provider, the request will go through the prior authorization process. The process to obtain prior authorization varies from insurer to insurer but typically involves the completion and faxing of a prior authorization form; according to a 2018 report, 88% are either partially or entirely manual. [5]
There is a continuum of organizations that provide managed care, each operating with slightly different business models. Some organizations are made of physicians, and others are combinations of physicians, hospitals, and other providers. Here is a list of common organizations: Group practice without walls; Independent practice association
The Tricare logo. Tricare (styled TRICARE) is a health care program of the United States Department of Defense Military Health System. [1] Tricare provides civilian health benefits for U.S Armed Forces military personnel, military retirees, and their dependents, including some members of the Reserve Component.
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Blue Cross and Blue Shield of Alabama (BCBSAL) is a nonprofit health insurance company headquartered in Birmingham, Alabama. The company was founded in 1936, provides coverage to more than 3 million people and is a member of the Blue Cross and Blue Shield Association (BCBS). BCBSAL employs nearly 5,000 people, which includes almost 3,500 people ...
For example, a study published in 2016 found that the average requested 2017 premium increase among 40-year-old non-smokers was about 9 percent, according to an analysis of 17 cities, although Blue Cross Blue Shield proposed increases of 40 percent in Alabama and 60 percent in Texas. [252] However, some or all these costs were offset by tax ...
In medicine, referral is the transfer of care for a patient from one clinician or clinic to another by request. [ 1 ] [ 2 ] Tertiary care is usually done by referral from primary or secondary medical care personnel.