...step of the strategic planning process builds on the last, it is important to complete the steps in the order listed above. Learning Team A will go through the strategic planning process for Blue Cross/Blue Shield. SWOT Analysis of BlueCross/BlueShield Health insurance is something that all Americans should think about before buying. There are many health insurance companies; some larger than others. When buying health insurance, consumers may want to consider the type of coverage needed, and the price of the coverage. As the cost of health care increases, health insurance rates increase also. BlueCross/BlueShield is one of the leading health insurance companies in America. Even though Blue Cross/Blue Shield is one of the leading health insurance companies, the company must offer affordable healthcare insurance policies and a variety of benefits and coverage to accommodate every individual’s needs. When talking benefits and coverage, this company must consider their members: whether the members are employed, self-employed, or retired and the benefits and coverage should be made to fit their needs. Higher healthcare rates can cause Blue Cross/Blue Shield to increase their insurance rates, which poses higher rates for the members. Because of the service Blue Cross/Blue...
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...Katrina V Wallace Education Midlands Technical College - Associates of Science, Business Admin, Expected Fall-2014 Minor in Psychology Professional Experience Medical Service Technician (contract Position) December 2012-April 2013 Blue Cross Blue Shield of South Carolina, Columbia, SC • Accurately handled both incoming Provider/Member correspondence and telephone calls. • Responsible for outbound contacts to Providers/Members in order to resolve inquiry issues. • Advised Medical Providers, Facilities, and Members of Pre-certification/ Authorizations policies & procedures • Strong Understanding of medical terms. • Able to communicate standard medical terms to customers. • Work with highly sensitive information while maintaining Personal Protected Information (PPI) requirements. • Conduct routine research with understanding and knowledge of medical, pharmacy, and Blue Cross Blue Shield Association guidelines and policies. • Other duties as assigned. Qualified Independent Contractor Assistant (contract position) BlueCross BlueShield of South Carolina, Columbia, SC April 2012- November 2012 • Provides all redetermination case file information within the specified time requirement • Suspends claims in applicable claim system and tracks all data • Maintained accuracy and departmental standards • General office and clerical duties, and maintaining a professional...
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...Jean-Batiste, Owner of Bolt Courier Services S. J. B. DATE: May 6, 2010 SUBJECT: Benefit Plans for Human Resource Management This is a brief memo to discuss with everyone the benefits that I think we should incorporate for our employees in our Human Resource department at Bolt Courier Services. These benefit plans should help improve our employee’s benefit selections. I will discuss the different benefits that we will implant for our human resource department as well as for other employees. The different plans are as follows; health care, retirement plans, our legal services, the way time off will work for each employee, and our employee assistance programs. HEALTH CARE INSURANCE: Employees will have a chose to either use COBRA, Blue Cross Blue Shield, or Mutual of Omaha for their dental, doctor’s visits, and other health issues as their insurance provider. Depending on how many are in their households will depend on the cost of for each employee per month. They can either have their payments deducted from their checks on payday or they can choose to make payments on their own to the company they chose. RETIREMENT PLANS: We can offer employees who are the age of 65 or older will have a chance to decide if they would want to retire or not. Alone with 401 (k) savings plan we can offer employees who may retire a pension plan of defined-contribution. This will help retires with their pension funds in the long run of working for the company. LEGAL SERVICES: So many employees...
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...Memorandum To: Dr. Robert I. Grossman, CEO NYU Langone Date: November 7, 2012 Re: Restructuring Health Care Payment and Improving Quality The U.S. devotes a much larger share of its national income to health care than any other country in the world. However, the gross over-spending has not yielded the healthiest population (OECD Health data, 2009). Our economy is continually growing at a lesser rate than healthcare spending. The need to restrain this unsustainable growth in health care costs is often overlooked in favor of reform focused on expanding access to care. Attention must be focused on restructuring the payment process with the goal of reducing costs without sacrificing quality. With an aging population comes chronic conditions that require efficiently coordinated care. About 10 million Americans require long term care, 42% of which are under 65 with disabilities or chronic illness (Rowland, 2009). It is also not uncommon for chronic patients to receive duplicate testing, conflicting treatment advice, and expensive prescriptions from multiple practitioners. The Medicare system was a fee-for service payment plan, until a prospective payment was introduced. A contributing factor to the problem has been the trending of hospitals and insurers to better cover acute episodes rather than preventative or ongoing care. For example, the average length of stay is down from less than 8 days in the 1970s to 4.6 days in late 2000’s. In a similar trend, gross outpatient...
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...There are several health insurance companies around the world that have been able to sustain the economic downturn. Just to mention a few of the major health insurance which are: WellPoint, Cigna, Aetna, Humana, Blue Cross Blue Shield and United Healthcare group that have ranked in the top ten list of health insurance. Everybody's talking about health care. It's too expensive; too complex; too exclusive. While there's a lot of debate about what can be done to fix it, there's one thing that cannot be refuted: we need health insurance. Going without health insurance is a constant stress and worry. Not only is there a nagging threat of serious things happening- where a week in the hospital can cost as much as many make in an entire year - but even the cost of a simple doctor's visits and prescriptions can empty your wallet faster than you can fill it. With the importance of health insurance comes the necessity to pick the best health insurance company for our needs. So the company I choose to discuss that I think has the best health insurance plans to me is United Healthcare because I have had experience with three out of the six insurance companies I mentioned above. United Healthcare is a division of the United Health Group. The organization is the largest health carrier in America; they are top contenders in leading the industry in the insurance business, customer service, community involvement, and philanthropy contribution. The company originated in 1977 and continues to...
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...Follow BI HOME Latest Tech Enterprise Science Finance Markets Your Money Wealth Advisor Politics Military & Defense Law & Order Strategy Careers Advertising Retail Small Business Life Education Transportation Entertainment Sports SPONSORED SECTIONS Above And Beyond The Anywhere Workplace The BI Interview The Fast Track Q&A Life Plan Out Of Office Tech 360 Think Global Tours Of Duty MORE Newsletters Companies Authors Categories ABOUT BI Careers at BI Masthead Contact Contributors FAQ Legal Fine Print Send Feedback View Full Site Copyright © 2014 Business Insider, Inc. All rights reserved. VIEW Business Insider What you need to know. On your iPhone. FREE - On the App Store. Search Business Insider Search The Illustrated Guide To A Ph.D. Matt Might, Matt.Might.Net Mar. 16, 2012, 2:43 PM 840,451 31 Every fall, I explain to a fresh batch of Ph.D. students what a Ph.D. is. It's hard to describe it in words. So, I use pictures. Read below for the illustrated guide to a Ph.D. Imagine a circle that contains all of human knowledge: By the time you finish elementary school, you know a little: By the time you finish high school, you know a bit more: With a bachelor's degree, you gain a specialty: A master's degree deepens that specialty: Reading research papers takes you to the edge of human knowledge: Once you're at the boundary, you focus: You push at the boundary for a few years: Until one day, the boundary gives way: And, that dent you've made is called a Ph.D.:...
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...Thank you for calling Blue Cross Blue Shield of ____ My name iand i will be you licensed sale agent today ,how are you today? ________ told me that you are looking for a _______ is that corrected? _____ told me that you have a question about ______ is that corrected? I will be more happy to assist you Just to inform you it is open enrollment and your effective date would be 1/1/15 if your enroll today Would it be okay if i can ask you some question to better assist you Need Assessment question 1. Would it be an individual or family? 2. Were you offered insurance through your employer? 3. How many times would you say you visit the doctor? 4. What would the natural of these visits 5. Are you taking any prescribe medication? 6. Do you have a doctor you like to keep? Or would you like me to find you a doctor near your area 7. Would you be interested in dental plans Notes This plan would be an_______ and they were _____ offered insurance through employer. They visit the physician ____ and the reason for the visit______. They are _____ taking medication list are____ . The doctor they have pick is____ and the ipn#____/ Inform them if the provider is not in the network they can give a call to their provider and see if they are going to taking the network for___ advise them to call member services to give them a doctor of choices. They are ____ interested in a dental plan (If they qualify for the tax credit) May I interest you in the estimate...
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...Most Important Skills to have in Customer Service 1. Patience When a customer contacts you about a problem, they’re normally not happy. So its not a good idea so say something that will make them more unhappy. Watch this. Employee: Thanks for calling Max express, this is Jennifer. Client: Yeah you’re company promised me a delivery on Tuesday and now its Saturday and its still not here. Do you have any idea what kind of problems this is causing me?!! Employee: Maam please, Calm Down. Client: Calm down? Don’t tell to calm down. If you’re company would’ve done what you promised we wouldn’t be having this conversation. Instead of focusing on the customer’s concern, Jennifer instructed the customer how to react which led to an argument. Patience is one of the toughest skills to hone especially if it doesn’t come naturally. This call could’ve been handled much better watch this. Employee: Thanks for calling Max express, this is Jennifer. Client: Yeah you’re company promised me a delivery on Tuesday and now its Saturday and its still not here. Do you have any idea what kind of problems this is causing me?!! Employee: We apologize for the inconvenience, that’s got to be very frustrating. Let me help you with that, what I can do is send a rush request so we can send your shipment overnight. Client: Okay thanks. (Relieved) That was much better, Jennifer showed her sympathy to the caller by apologizing and focused her efforts in solving the problem and that’s...
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...2006). These thinkers think about what their thinking and may ponder on what one is thinking and then these thinkers act upon that thought (Paul & Elder, 2006). The best thinkers use critical thought in the workplace and create many solutions to different issues or problems within an organization. In organizations, it is important for an organization to develop employee’s critical thinking skills. Employees who think about what the individual is thinking and come up with the best alternative solutions can hold a competitive advantage over competitors (mindtools.com, 2010). Blue Shield of California (BSC) is a leading health insurance company in the state of California. There are many departments within this organization and one department is known as the Blue Card Department. There are two sides to this department; one is called the Host side who deals with California providers who render services to other Blue plans members. The other part of this department is the Home department. The Home department handles BSC members who receive medical...
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...2012 Video Case Study: Phelps Group: Building Brands Through IMC How interesting is this topic since my maiden name is Phelps, of course, no relation. As I listened and read through this video case study, it felt as though I was watching a movie and these were the commercials I viewed during the break. The branding strategy the Phelps Group used to implicate Blue Shield 65 Plus is brand extension, where the existing name of Blue Cross Blue Shield extends to a new category. Based on the communications elements shown for Blue Shield 65 Plus (ads, print material, etc.), answer the following. Explain your answers. Describe the target market with which Blue Shield 65 Plus wants to communicate? The target market would include senior citizens that are 65+ who are Medicare recipients, retirees and plan service area residents. These people are also self-reliant and lead active lives. They do not want to have to depend on others to help them if there are sufficient means available. Channel members (those who influence the target-market members) can be communicated with as well. What effect does Blue Shield 65 Plus want its communications to have on the target audience? It wants their target market to understand that nobody knows them like them. They also want them to know that the program is flexible, customized and simple, just for them. The male in the commercial appears to be happy and has the feeling self-reliance. This program is consistent with the self-concept...
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... [pic] • IMAGINGORDER table with the following columns: 1. OrderNumber 2. ImDate 3. Organ 4. Reason 5. Diagnosis [pic] • LABORDER table with the following columns: 1. LabOrderNumber 2. OrDate 3. ReqBloodTest 4. Reason [pic] • INUSRANCEINFO table with the following columns: 1. MemberID 2. GroupID 3. Provider 4. ProviderPhone 5. ProviderAddress [pic] 2. Add CHECK constraints to the INSURANCEINFO to limit Provider column to be within the following group only (United, AvMed, Blue Cross Blue Shield, Medicare, Medicare) [pic] 3. Add a column to the PATIENTPER table called AdmissionDate [pic] 4. INSERT at least three rows into each table. 5. Use the proper columns to...
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...The Role of Health Insurance Companies in Disease Management Abstract This paper will analyze the increase in healthcare costs that has attributed to a trend in health insurance plans’ and employer groups focus on disease management through emphasis on wellness programs (Ex; health club credits), and disease management with the hopes of preventing and decreasing the number of insured’s with chronic illnesses. Disease management is defined as a systematic approach to coordinated health care that seeks to identify individuals and populations who are at risk of developing certain chronic medical conditions. In the past couple of years, health insurance companies such as Blue Cross Blue Shield, Aetna and United HealthCare have implemented various extensive disease management programs with a goal of prevention rather than cure. The Role of Health Insurance Companies in Disease Management The main goal of chronic disease management is to help patients self-identify any irregularity before the condition progresses to a life threatening. More than 133 million Americans, or 45 percent of the population, have at least one chronic condition. These conditions include but not limited to; arthritis, asthma, cancer, cardiovascular (heart) disease, and diabetes, though these are only a few of many chronic illnesses that negatively impact the lives of Americans (Centers for Disease control, 2013). According to a survey conducted by Hewitt Associates (2001), 76 percent of employers...
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...SUMMARY OF EMPLOYEE BENEFITS This summary of benefits is provided for information only. Increase of any inconsistency between this summary and the formal benefit plan, the formal benefit plan will apply GROUP MEDICAL, PRESCRIPTION, DENTAL, AND VISION PLANS MEDICAL/PRESCRIPTION In- Network coverage For 2016 we offering two Preferred Provider Organization Plans (PPO) through BlueCross BlueShield of Texas. TSL is proud to offer a company paid medical plan (PPO Base Plan). PPO Base plan has a deductible of $2,500 for individuals and $5,000 for families. After the deductible is meet the plan converts into a 70%/30% coverage plan. PPO (Buy-Up) plan has a deductible of $3,000 for individuals and $6,000 for families. After the deductible is meet the plan converts into a 100% covered plan. Preventive Care is covered at 100%. DENTAL In-Network Coverage For 2016 we are offering three dental plans. All three plans are though Guardian. DHMO has a zero deductible, you pay a fixed dollar amount for treatments (a copayment will apply) **See Copay Schedule**. Plan 2 PPO Value Plan has a deductible of $50 for individuals and $150 for families. Plan 2 requires that you use a pre-screened, in-network dentists. Plan 3 PPO Network Access Plan (NAP) Plan has a deductible of $50 for individuals and $150 families. With Plan 3 you may see any dentist of your choice. Preventative Care is covered at 100%. VISON In-Network Coverage Vision coverage is provided though Guardian. This is...
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...American Legion Auxiliary Health Care Scholarship: This $300 scholarship is awarded to students pursuing a health care career. To qualify, students must have completed two semesters in college with at least a 3.0 GPA. To apply, contact the secretary treasurer of the American Legion Auxiliary through their mailing address at PO Box 2198, Gillette, Wyoming 82717. Blue Cross Blue Shield Scholarships: The Blue Cross Blue Shield provides two separate $500 awards for students majoring in a career in the health care industry. To apply, students should contact their financial aid office. Margaret L. Hageman Scholarships: The amount of this award can vary, up to $600 for a semester. Students must be pursuing a career as in the nursing field, either as a registered nurse, or as registered nurses who are going back to school to advance their career. Contact the Wyoming Nurses Association for more information, by mail at 1603 Capitol Avenue, Suite 305, Cheyenne, Wyoming 82001. University of Wyoming License Plate Funded Scholarships: Application information can be found on the license plate scholarship website. These scholarships award $750 per semester and are renewable for students obtaining a 2.5 GPA or higher. They are aimed towards non-traditional students and include the following scholarships: * Outreach Scholarships * Non-Traditional Undergraduates scholarships * Fifth and Six Year Undergraduates scholarships * Second Bachelor’s Degree scholarships University of...
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...The Business Environment I believe businesses have a huge role in today’s economy. The most important role I believe is providing jobs, which is a necessary part that business plays in any and all economies. The economy of the country is dependent upon the employment provided by big and small businesses and production of goods and services that we rely on in our day to day lives. Without businesses, you are unable to have any sort of a free market economy. Businesses also tend to provide the innovations and or an idea that makes the markets grow. Small businesses employ large numbers of people. They are necessary to molding a sense of independence, risk-taking, self-reliance, and personal achievement The comparisons and differences of Non Profit and For-Profit organizations and similar but yet still not the same you have to understand the meaning of profit. In business, profit is a word used to describe earnings. A nonprofit organization has a mission that benefits the community, society, or the world at times. It doesn’t any pay taxes, but it also cannot use its funds for anything other than the mission for which it was formed. Nonprofit organizations can and do make a profit, but it must be used only for the operation of the organization. The strength of a nonprofit is its efficiency in meeting consumer demands at minimal cost. Non-Profits meet these demands through work performed by volunteers, tax deductible contributions by taxpayers and direct government assistance ...
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