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Utilization management is "a set of techniques used by or on behalf of purchasers of health care benefits to manage health care costs by influencing patient care decision-making through case-by-case assessments of the appropriateness of care prior to its provision," as defined by the Institute of Medicine [1] Committee on Utilization Management by Third Parties (1989; IOM is now the National ...
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A number of legislative and technological developments attempt to optimize the prior authorization process: [16] In 2011, the American Medical Association recommended a uniform prior authorization form with real-time electronic processing. The proposed process would involve a physician ordering a medical service, their staff completing a ...
In addition to the support options listed above, paid members also have access to 24/7 phone support by calling 1-800-827-6364. Popular Products. Account; AOL Mail;
In 1996, The Associated Group changed its name to Anthem Insurance Company. [17] In August 1997, Anthem acquired Blue Cross and Blue Shield of Connecticut. [18] It also sold Acordia to management. [19] In 1999, Anthem acquired Blue Cross and Blue Shield of New Hampshire and Blue Cross and Blue Shield of Colorado and Nevada. The acquisitions ...
Blue Cross Blue Shield Association, also known as BCBS, BCBSA, or The Blues, is a United States–based federation with 33 independent and locally operated BCBSA companies that provide health insurance to more than 115 million people in the U.S. as of 2022.
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In West Virginia, the company operates as Highmark Blue Cross Blue Shield West Virginia, and in Delaware, it operates as Highmark Blue Cross Blue Shield Delaware. The new company based its head offices in downtown Pittsburgh. On March 28, 2007, Highmark announced it intended to consolidate with Independence Blue Cross of Philadelphia. The ...