Blue Cross and Blue Shield Association Essays

of the Great Depression. Blue Cross covered the cost of care when a patient was treated at a hospital. There was a need for more integration between what was going on in an outpatient and what was going on in an inpatient, thus by 1932 Blue Shield was formed. It provided doctors to subscribers when they paid monthly premiums. It was expanded to larger communities eventually to all of the United States. Although they were separate companies, in 1938 Blue Cross and Blue Shield merged offering low cost

Disadvantages Even though the advantages outweigh the disadvantages of informed consent, it is still vital to talk about the shortcomings involved. It is important for health care professionals to understand the disadvantages of informed consent just as much as the advantages so that they can prevent these drawbacks, if possible. The disadvantages I will be discussing in this section is the act of coercion and undue influence, emergency situations and special circumstances where informed consent

get coverage previously. In order to achieve this policy, the new act made health insurance mandatory. If you fail to carry coverage you can potentially be fined. The law also prohibits all health care companies like Humana, WellCare, and Blue Cross Blue Shield from charging higher premiums to patients with pre-existing conditions. Children and young adults up to the age 26 can remain on their parent’s medical coverage. I am a living witness to these financial burdens. In 2010 I was diagnosed

provides insurance cover to an individual, a group of people or to an organization (Thomas, 2000). However, in this case we will compare medical benefits of Blue Cross Blue Shield Health Insurance Company (BCBS) and United Healthcare (UHC). It is a leading health insurance provider in the world. BCBS is not a wide national company but rather an association of smaller independent health insurers.

how health insurers rip off you and your employer Wendell Potter exposes some hidden facts about how the health insurance company BCBSM has been cheating on one of its costumers Hi-lex. It all started when Hi-Lex’s company suspected that the Blue Cross Blue Shield of Michigan (BCBSM), Health Insurance Company was dishonest with them for 19 years. The documents filed in the case showed that in the year 1993 BCBSM executed a plan through which it would gather extra income by including certain mark-ups

practitioners ranging from the technical performance to interpersonal relationships depends on quality of the services. Healthcare fraud and abuse are some of the issues affecting the quality of healthcare services. According to the Blue Cross Blue Shield Association (2016), healthcare fraud is a felony in various states regulations that can occur in the form of deceits inside the healthcare systems purposively for illicit growth. On the

addition, insurance policies are often confusing and difficult to determine the level of coverage that can be expected. For instance, Blue Cross Blue Shield of Michigan (BCBS) asserts that “employers can customize the plans they offer. They may change which autism benefits are included, what you need to do to get them, or choose to omit them” (Blue Cross, Blue Shield: Blue Cross Network of Michigan, n.d.). Health Alliance Plan (HAP) does not cover diagnosis or treatment of ASD for anyone over the age of

insurance giant in the US, is challenged in the court, more emergencies may be denied payment and the bill left in the hand of patients. The policy, although it will apply to six states, will be rolled out in all 14 states where Anthem has Blue Cross Blue Shield affiliates. The American College of Emergency Physicians and other groups asked Anthem to reconsider the policy. Dr. William Thorwarth, the CEO of the American College of Radiology, said that if doctors would not challenge the rule, other

P., Halverson, P. K., Kaluzny, A. D., & Norton, E. C. (2001). How managed care plans contribute to public health practice. Inquiry - Blue Cross and Blue Shield Association, 37(4), 389-410. Retrieved from

In the early twentieth century, when hospitals had just begun sprouting and organized health care had just developed, doctors and treatment were limited and shoddy. After the installation of non-profit healthcare programs in the early 1930’s, workers were reassured, knowing that a mishap at work would not erase their bank savings. Seeking profit, private businesses scrambled into the healthcare marketplace. The sudden influx of private insurers left the original non-profit insurances in the dust

Tovero pattern horse has one or both eyes blue; it has dark pigment around the mouth and ears. Some foals are born without color patterns (The American). Sabino has a different white pattern than the others. People can say Sabinos look like roan because the coat is not solid; it has white hairs mixed in the coat. Most of the time, Splashed White patterned horses have blue eyes and little white. The Medicine Hat pattern has a dark cap on the horse’s poll or a shield on its’ chest. People believed these

medical education became prevalent around 1870 when “The Association of American Medical College (AAMC)” was founded in 1876 that further extended set minimum standards for medical education. In 1929, Baylor Hospital in Dallas, TX offered to a group of teacher’s medical services at a predetermined motherly cost. This plan is considered the forerunner of the current Blue Cross and Blue Shield health insurance insurance plans. The American Association of Labor Legislation (AALL) was founded in 1906 which

editorial team analyzed other reputable hospital ranking and award sources such as National Rural Health Association, iVantage Health Analytics, U.S. News & World Report, Truven Health Analytics, Healthgrades, CareChex, Leapfrog, American Nurses Credentialing Center, etc. Metrics used for 100 Hospitals With Great Orthopedic

The healthcare industry is a critical sector in the US economy, providing essential health services to the growing and aging population. As demand for healthcare services increases, it becomes even more crucial for the industry to offer affordable and high-quality care. Competition is vital in the healthcare industry as it ensures that patients have access to fair-priced care. Antitrust and competition laws play an essential role in promoting competition in the healthcare industry, preventing monopolies

multi-state PPO plan. This plan allows the eligible student to receive coverage under the health plan without huge out of pocket cost for medical attention. Currently, the only health care provider that offers the multi-state PPO plan is Blue Cross Blue Shield Association. The multi-state PPO plan is available within 35 states and the District of Columbia and by 2017 the Patient Protection and Affordable Care Act requires all states to offer this PPO plan (Obama Care Facts,

American to afford. In response to this a group of teachers decided to form an organization that would agree "to prepay for future medical services (up to 21 days in advance)" However this organization was only for teachers and was the precursor to Blue Cross. In order to not anger private physicians, this also only covered hospital charges so that private

require funds to assist in the continuation and the revolving of healthcare services. References Casto, A. B., & Layman, E. (2006). Principles of healthcare reimbursement. Chicago, Illinois: American Health Information Management Association. Retrieved from http://www.amcp.org/WorkArea/DownloadAsset.aspx?id=12724 Health Care Reform. (2014, January 1). Retrieved October 18, 2014. http://www.hca.wa.gov/hcr/Pages/default.aspx Indian Health Service The Federal Health Program for American

evaluating the risks of patients for certain medical conditions that it could be used against them. This is a rational fear, as many insurance companies use your health records and history to evaluate the cost of insurance for their customers. Many Blue Cross/Blue Shield insurance plans will turn down applicants if there is presymptomatic testing that shows they are at risk of a disease. It has even been stated by the Alliance of Genetic Support Groups that genetic information from participation in research

According to a survey conducted in 2011 by the Substance Abuse and Mental Health Services Administration (SAMHSA), almost five million individuals, who had a need for psychiatric services, did not receive mental health care. When questioned about the reasons for not receiving care, 50% of the population of adults eighteen and older stated that cost of care was the main barrier to treatment (Citation, 2011). The average cost of care for a pediatric inpatient stay for mental health exacerbations

Program Description A DNP PMHNP ran private practice with a mission to improve the well-being of individuals through ensuring the receive compassionate, evidenced based mental healthcare through direct treatment, education and consulting. The practice will serve primarily healthcare workers and first responders to address the mental health needs through the use of therapy and medication management as appropriate. Additionally, the PMHNP will provide consultation and educational sessions to health