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Glossary

We've compiled a list of common health care and health insurance related terms to help you better understand words commonly used in our industry and on our web site.

Terms appear in alphabetical order. To use the glossary, please choose the first letter of the term you would like to view.

A|B|C|D|E|F|G|H|I|J|K|L|M|N|O|P|Q|R|S|T|U|V|W|X|Y|Z


A

 

ACCOUNT
An entity or organization applying for health insurance coverage under terms of a specific contract - frequently contains more than one group.

ACCOUNT NUMBER  
A unique number assigned to an account by Capital BlueCross in order to administer health care coverage and associated administrative services.

ACCREDITATION
The process by which an agency or organization evaluates and recognizes a program of study or an institution as meeting certain predetermined standards.

ADMINISTRATIVE SERVICES ONLY (ASO) 
An arrangement under which an insurance carrier or independent organization handles, for a fee, the administration of claims, benefits, and other administrative functions for a self-insured group.

ANNIVERSARY DATE
The date on which an account is re-enrolled each year subsequent to its initial enrollment.

APPEAL
A written request questioning the Plan's adverse determination affecting a member's claim or eligibility.

APPLICATION
The written request for coverage under a contract on a form furnished by the Plan.

ASSOCIATION GROUP
A group formed from members of a trade or a professional association for group insurance under one master health insurance contract. To qualify as an association group, the group must meet and maintain the underwriting criterion of Capital BlueCross.