Bcbs Legal Risk
Driven by the mission to provide access to quality healthcare, BCBS subsidiaries are committed to developing a world-class audit, risk and compliance management framework. As the number of compliance requirements increased, members needed a robust and integrated system that could strengthen the company`s existing compliance strategies, mitigate risk, and protect patient interests. These terms and conditions constitute the entire agreement between you and BCBSA with respect to your use of the Site. If any part of these Terms and Conditions is held to be invalid or unenforceable for any reason, the remaining parts will remain in full force and effect. You acknowledge that BCBSA has relied on your consent to be legally bound by these Terms and Conditions to provide access to and use of the Site. Risk adjustment aims to improve the conditions of competition by preventing adverse selection of members through a two-step process: risk assessment, which assesses a person`s health risk to create a clinical profile; and risk adjustment, which estimates the use of resources needed to provide medical care to a person. Nothing contained, expressed or implied by this website is intended or may not be construed or construed as legal advice, guidance or interpretation. There is no relationship between BCBSA and you as a result of your use of this website or in any circumstances. The information on this website is for general information purposes only. If you have any questions about the laws, articles, regulations or requirements to which reference is expressly or implicitly made on this website, you should contact your own legal counsel.
After reviewing several compliance solution providers, MetricStream was selected for its holistic approach to compliance, auditing, risk and problem management, expertise and comprehensive solution capabilities, as well as its successful track record in the health insurance industry. “CMS should use all available legal means to make payments on time and should do so to protect consumers. Starting with the 2018 reporting year, prescription drug data will be included to improve the risk adjustment model. The pharmacy and prescription of the hospitalized patient are included. This will help to better account for the health risks of people with serious health problems. This website and the information contained therein do not constitute an offer or solicitation of an offer to buy or sell any securities. The Site contains information and press releases about BCBSA, and although such information has been believed to be accurate at the time of writing, BCBSA disclaims any obligation or obligation to update such information. To the extent that the information is considered “forward-looking statements” within the meaning of the rules and regulations of the Securities Act of 1933, as amended, such information is intended to be part of the “safe harbor” of forward-looking information and is subject to material risk factors that may or may not be disclosed herein. The platform also enables them to take a consistent approach to compliance by breaking down restrictive silos and creating more collaborative workflows. It provides a centralized framework for managing all compliance processes, ranging from regulatory monitoring, control assessment, monitoring, issue management, risk analysis, reporting, and documentation. These Terms and Conditions shall be governed by and construed in accordance with the laws of the State of Illinois, without reference to its choice of law rules.
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