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Until the middle of 2015 insured individuals paid their premiums to the Washington Health Benefit Exchange, since then payments are made directly to the insurance company. The Exchange is responsible for the creation of Washington Healthplanfinder, the online portal to facilitate the shopping and enrolling in health and dental insurance.
In November 1991, the Workgroup for Electronic Data Interchange (WEDI) was established in response to the challenge from the Bush administration, specifically, Louis Sullivan MD, Secretary of HHS, to reduce administrative costs in the nation's health care system by up to 10%.
With indemnity dental plans, the insurance company generally pays the dentist a percentage of the cost of services. Restrictions may include the co-payment requirements, waiting period, stated deductible, annual limitations, graduated percentage scales based on the type of procedure, and the length of time that the policy has been owned.
The Delta Dental Plans Association, also known as simply Delta Dental, is an American network of dental insurance companies composed of 39 independent Delta Dental members operating in all 50 states, the District of Columbia and Puerto Rico. These member companies provide coverage to 85 million people, enrolled in over 157,000 groups.
In order to be clear on the payment of a medical billing claim, the health care provider or medical biller must have complete knowledge of different insurance plans that insurance companies are offering, and the laws and regulations that preside over them. Large insurance companies can have up to 15 different plans contracted with one provider.
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A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). The NPI has replaced the Unique Physician Identification Number (UPIN) as the required identifier for Medicare services, and is used by other payers ...
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