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  2. Prior authorization - Wikipedia

    en.wikipedia.org/wiki/Prior_authorization

    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.

  3. Blue Cross Blue Shield Association - Wikipedia

    en.wikipedia.org/wiki/Blue_Cross_Blue_Shield...

    Blue Cross and Blue Shield insurance companies are licensees, independent of the association and traditionally of each other, [16] offering insurance plans within defined regions under one or both of the association's brands. Blue Cross Blue Shield insurers offer some form of health insurance coverage in every U.S. state.

  4. L.A. Care Health Plan - Wikipedia

    en.wikipedia.org/wiki/L.A._Care_Health_Plan

    In April 2010, L.A. Care was awarded a federal grant to establish a Health Information Technology Regional Extension Center (REC), called HITEC-LA, to help doctors in L.A. County adopt and use Electronic Health Records (EHRs). [19] HITEC-LA is the sole REC in L.A. County, under the terms of the grant.

  5. Health maintenance organization - Wikipedia

    en.wikipedia.org/wiki/Health_maintenance...

    The Farmer's Union took control of the hospital and the health plan in 1934. Also in 1929, Baylor Hospital provided approximately 1,500 teachers with prepaid care. This was the origin of Blue Cross. Around 1939, state medical societies created Blue Shield plans to cover

  6. Managed care - Wikipedia

    en.wikipedia.org/wiki/Managed_care

    [4]: 2 In the period between 1910 and 1940, early healthcare plans formed into two models: a capitated plan (essentially an HMO), and a plan which paid service providers, such as the Blue Cross and Blue Shield Plans. [4]: 2 One of the earliest examples is a 1910 "prepaid group plan" in Tacoma, Washington for lumber mills.

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  8. John Fleming (American politician) - Wikipedia

    en.wikipedia.org/wiki/John_Fleming_(American...

    [140] [141] [142] He explained that the cause of this burden is due primarily to three major areas: outdated clinical record guideline requirements designed for billing purposes, prior authorization requirements, and health care quality measurement and reporting.

  9. Steward Health Care - Wikipedia

    en.wikipedia.org/wiki/Steward_Health_Care

    St. Elizabeth's Medical Center in Brighton, MA, which served as Steward's flagship hospital until it was sold in 2024 [19]. Steward Health Care was founded in 2010, when Caritas Christi Health Care was sold to New York private equity firm Cerberus Capital Management, with Caritas CEO and former Beth Israel Deaconess Medical Center heart surgeon Ralph de la Torre continuing as CEO of the new ...

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