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In 1995, The Associated Group acquired Community Mutual Insurance, a provider of Blue Cross and Blue Shield insurance plans in Ohio with over 1.9 million policy holders), then set up Anthem Blue Cross and Blue Shield. [16] [17] In 1996, The Associated Group changed its name to Anthem Insurance Company. [17]
In the United States, an exclusive provider organization (EPO) is a hybrid health insurance plan in which a primary care provider is not necessary, but health care providers must be seen within a predetermined network. Out-of-network care is not provided, and visits require pre-authorization.
An Exclusive Provider Organization plan, like a POS, combines different facets of basic HMO and PPO plans. Unlike POS and HMO plans, however, EPOs allow you to choose your own PCP and see ...
Unlike EPO members, however, PPO members are reimbursed for using medical care providers outside of their network of designated doctors and hospitals. However, when they use out-of-network providers PPO members are reimbursed at a reduced rate that may include higher deductibles and co-payments, lower reimbursement percentages, or a combination ...
As Highmark Blue Shield, it is available in 21 counties in Central Pennsylvania and the Lehigh Valley. It also has a presence in the border areas of eastern Ohio, and all of West Virginia through its subsidiary, Highmark Blue Cross Blue Shield West Virginia. Highmark acquired Blue Cross of Northeastern Pennsylvania, BCNEPA, in June 2015. [4] [5]
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 ]
AHN Wexford is a 160-bed, $313 million, 345,000-square-foot hospital built along Route 19, north of Pittsburgh. [11] Opened in the fall of 2021, AHN Wexford is the network's newest full-service hospital, and includes a 24-bed emergency department, operating rooms with minimally invasive robotic surgery capabilities; a cardiac catheterization lab and hybrid OR for advanced surgical procedures ...
Health Insurance Plan of Greater New York (HIP) was incorporated in 1944 as the first health insurance plan for public service workers. [9] The company was founded by David M. Heyman with the support of New York City mayor Fiorello La Guardia, who wanted to offer medical services to New Yorkers of “moderate means.” [10] HIP got its first members in 1947.