Others / Blue Cross Blue Shield
Blue Cross Blue Shield
Introduction
Discussing Blue Cross Blue Shield Association’s methodology research is the main theme of the paper’s discussion. It seeks to find out relevant implications that this association can bring to our society. In this case, Blue Cross Blue Shield Association or BCB SA is considered as a federation of 36 different separate US health insurance firms and institutions that are responsible for providing medical insurances to Americans. The association is founded in 1929 and now became one of the leading providers of insurance benefits to 106 millions of Americans across the country. The main responsibility of the company is to ensure that there is an affordable health care for all individuals or groups who are seeking to improve their medical condition in hospitals and clinics.
As for the first methodology, the content indicates the facility scoring methodology that identifies the qualitative process that seeks to identify the cost efficiency and the quality of the institution’s services. The results will ensure if it really applies with the main vision of the company is to ensure that there is an accessible health care practices to everyone who wants to increase its longevity and preserve their health from environmental threats. The service is through medical assistance on its medical insurances. The methodology simulates the importance of the company if it does qualify into a Tier 1 status. This tier status indicates hypothesizes that the company is one of the leading corporations that provides the highest quality of insurance benefits for the companies. This is in relation to the product cost efficiency threshold for facilities, services, and the financial aspects of the company, especially when ensuring services that improves its net productivity (Horizon Blue, 2015).
The other methodological procedure is the Ambulatory Surgery Center Grouper. The purpose is to provide a set of guidelines to reimburse multiple procedures that are performed towards an ambulatory surgery center. The methodology approach also utilized a qualitative measure applied to the ambulatory surgery center of the company. There are limitations and exclusions that have been allotted that have been revealed under the methodology of the institution. As a result, the company efficiently measured the relevance of this particular aspect to monitor its competitiveness on a certain procedure. The methodology is applied on a yearly basis or when there are documented lapses affecting the services and productivity of the institution. This is to prevent future problems that might cause conflicting interests with the stakeholders (Blue Cross Blueshield of North Carolina, 2018).
As a learning insight, the methodology has been a successful implementation of productivity applied to the company’s services. This is important because as a company, there is more room for improvement in terms of promoting a responsible monitoring of services that are needed to improve the productivity of the company. The methodology is recommended for the reason that there are viable options for the health care institutions to identify a particular service that are needed to provide insurance benefits for selected patients. As a result, this procedure seeks to prevent any risk of losses with the company’s funding services as it concentrates on the supportive measure of its funds. Companies with similar interests seek to promote accessibility to health care services that are offered by multiple companies and clinics. This means that any results indicated from the methodology serves as a clear sign that there are either a problem, or a compliment with the company’s services.
References
Blue Cross BlueShield of North Carolina (2018). 2018 Facility Scoring Methodology for Blue Select. Accessed: https://www.bluecrossnc.com/sites/default/files/document/attachment/providers/public/pdfs/2018_blue_select_methodology_facilty_tiering.pdf.
Horizon Blue (2015). ASC Multiple Procedure Methodology. Accessed: https://www.horizonblue.com/providers/policies-procedures/policies/reimbursement-policies-guidelines/asc-multiple-procedure-methodology.
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