The facility is not used primarily for custodial, convalescent, tuberculosis or rest care care of the aged or substance abusers skilled nursing or other nursing care. These facilities primarily treat patients with conditions that require a hospital stay of fewer than 30 days.

The amount a health care provider would bill a patient for a particular medical service or procedure if there were no participation arrangement with a health care plan.Ī facility that offers a wide range of medical, surgical, obstetric and pediatric services. See also NCQA.Īn index or scale that measures an individual’s degree of independence in bathing, dressing, using the toilet, eating and moving across a small room.Īmount pharmacies actually pay for drugs, less any discounts, rebates and price or trade concessions. For example, the National Committee for Quality Assurance, a nationally recognized independent organization, evaluates managed care plans using objective, scientific measures. The process is often carried out by a private organization created for the purpose of assuring the public of the quality of an institution or program. The formal evaluation of an organization or a program by an external body according to certain predetermined standards.

This includes: strains, sprains, cuts and bruises allergic reactions caused by an outside force such as a bee sting or another insect bite burns, frostbite, sunburn, sunstroke swallowing poisons drug overdosing inhaling smoke, carbon monoxide or fumes attempted suicide. A patient’s ability to obtain appropriate health care services as needed.Īn independent, for-profit subsidiary of BCBSM that offers workers’ compensation and administrative services to employers.Īny physical damage caused by an action, object or substance outside the body.

Mckesson clear claim check