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by health care providers on prescriptions (however, the NPI will not replace requirements for the DEA number or state license number); by health plans in their internal provider files to process transactions and communicate with health care providers; by health plans to coordinate benefits with other health plans;
The X12 834 EDI Enrollment Implementation Format is a standard file format in the United States for electronically exchanging health plan enrollment data between employers and health insurance carriers. The Health Insurance Portability and Accountability Act (HIPAA) requires that all health plans or health insurance carriers accept a standard ...
An explanation of benefits (commonly referred to as an EOB form) is a statement sent by a health insurance company to covered individuals explaining what medical treatments and/or services were paid for on their behalf. [1] The EOB is commonly attached to a check or statement of electronic payment. An EOB typically describes:
The enrollment period for 2025 state-based insurance coverage is now underway. Previously known as federal marketplace insurance, Pennsylvania is using a state-based insurance program known as ...
Prior to October 1, 1985, DEA registration numbers for physicians, dentists, veterinarians, and other practitioners started with the letter A. New registration numbers issued to practitioners after that date begin with the letter B, F, or G. [3] [4] The rest of the format was the same as the new style.
The majority of insured US adults had at least one health insurance problem – including denial of claims – in the span of a year, according to a survey released in June 2023 by KFF, a ...
Health policy experts such as David Cutler and Jonathan Gruber, as well as the American medical insurance lobby group America's Health Insurance Plans, argued this provision was required in order to provide "guaranteed issue" and a "community rating," which address unpopular features of America's health insurance system such as premium ...
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