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WellCare Health Plans, Inc. is an American health insurance company that provides managed care services primarily through Medicaid, Medicare Advantage and Medicare Prescription Drug plans for members across the United States. WellCare began operations in 1985 and has its headquarters in Tampa, Florida.
Denied Claims. These claims are properly filed but do not meet the payor’s criteria for payment. Common reasons include billing for services not covered by the plan, highlighting the importance of verifying insurance coverage during patient registration. Denied claims require investigation to identify the issue and prevent future occurrences.
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 ...
In the United States, approximately 9.2 million people are eligible for "dual" status. [1] [2] Dual-eligibles make up 14% of Medicaid enrollment, yet they are responsible for approximately 36% of Medicaid expenditures. [3] Similarly, duals total 20% of Medicare enrollment, and spend 31% of Medicare dollars. [4]
In March 2019, it announced plans to acquire WellCare for US$17.3 billion. [13] [14] In January 2021, it was announced that it would acquire Magellan Health for $2.2 billion. [15] In January 2022, the acquisition was completed. [16] In the United Kingdom, Centene began to acquire local healthcare services in 2017. [17]
Centers for Medicare and Medicaid Services logo. Medicare Part D, also called the Medicare prescription drug benefit, is an optional United States federal-government program to help Medicare beneficiaries pay for self-administered prescription drugs. [1]
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Express Scripts Holding Company is a pharmacy benefit management (PBM) organization. In 2017 it was the 22nd-largest company in the United States by total revenue as well as the largest pharmacy benefit management (PBM) organization in the United States. [2]