Blue Shield of California

Overview

Blue Shield of California is a health insurance provider operating within the finance industry, specifically focusing on financial services and health insurance. With a workforce of approximately 7,500 employees and reported revenue of $25.4 billion, the company serves a diverse clientele through various health insurance products. The organization emphasizes compliance and regulatory oversight in its operations, as evidenced by its published document, the "HMO IPA/Medical Group Procedures Manual." This manual, which includes a supplement for Delegated Entities, outlines procedures related to claims processing, compliance programs, IT system security, and oversight monitoring. It serves as a guide for entities that handle claims on behalf of Blue Shield, detailing best practices, key definitions, and methodologies for measuring claims timeliness and accuracy. The focus on claims management and compliance reflects Blue Shield's commitment to maintaining regulatory standards and ensuring efficient operations within its health insurance offerings.

Industry