A payment method for health care services where the provider is paid a contracted rate for each member assigned (usually as a PMPM) regardless of the nature of services provided
The practice of a healthcare provider billing a patient for the difference between what the patients health insurance reimburse and what the provider charges
What is the nickname of the BCBSMA building on Summer Street
What important initiative started in 2009
What is the current survey on the 8th floor kitchen asking you to comment on (2 wds)
What risk adjustment model does CMS use for Medicare business
A provision of the MA health reform law and the ACA that requires individuals to purchase health insurance that meets minimum standards or pay a penalty.
Second largest physician hospital organization in BCBSMA's network by revenue
PIRS replacement in 2012
Total charges - ___ = Allowed Charges
Down
Profitable Growth, Blue for Life and ___ ___ _____
a metric to measure provider price variation
Number of associates in NPC Finance
BCBSMA's current pharmacy benefits administrator (abbrv)
Components of trend: cost, utilization and ____
Health care services like lab tests, X-rays, rehab, hospice care and urgent care. Not necessarily performed by docotrs but help doctors diagnose or treat a health condition
Who was the CEO fo BCBSMA for 13 years (last name)
State government agency created by Chapter 224 of the Acts of 2012, which was enacted to improve health care quality and contain health care costs through transparency, efficiency and innovation
State where the BCBS Association originated
What that of the week does the BCBSMA Boston walking club meet? (abbrv)
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