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Payors evaluate claims by verifying the patient's insurance details, medical necessity of the recommended medical management plan, and adherence to insurance policy guidelines. [4] The payor returns the claim back to the medical biller and the biller evaluates how much of the bill the patient owes, after insurance is taken out.
Catamaran Corporation (formerly SXC Health Solutions) is the former name of a company that now operates within UnitedHealth Group's OptumRX division (since July 2015). It sells pharmacy benefit management and medical record keeping services to businesses in the United States [3] and to a broad client portfolio, including health plans and employers. [4]
Software development efforts have been focused on the incorporation of artificial intelligence capabilities and workflow management tools in to the claims management systems in order to enable CorVel's unique process. In August 2010, CorVel introduced a provider look up app that can be accessed in the Apple Store and Google Play. This mobile ...
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Maryland's Health IT Extension Center became a reality in 2010 with a grant from the department of Health and Human Services for $5.5 million. [7] Today, CRISP has connected with all of the acute care hospitals in Maryland and DC, and has rolled out several new services, and dozens of new features.
Maryland had the longest special enrollment period of all U.S. states in 2020. The first special enrollment period ran from March 16, 2020, until July 15, 2020, and more than 54,000 people enrolled in health coverage. [ 3 ]
(Reuters) -The state of Maryland on Tuesday filed civil claims against the owner and operator of the cargo ship that struck the Francis Scott Key Bridge in March, killing six people and paralyzing ...