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The Sunshine Act requires manufacturers of drugs, medical devices, biological and medical supplies covered by the three federal health care programs Medicare, Medicaid, and State Children's Health Insurance Program (SCHIP) to collect and track all financial relationships with physicians and teaching hospitals and to report these data to the Centers for Medicare and Medicaid Services (CMS).
Medical billing, a payment process in the United States healthcare system, is the process of reviewing a patient's medical records and using information about their diagnoses and procedures to determine which services are billable and to whom they are billed. [1] This bill is called a claim. [2]
Blue Cross Blue Shield is an association of 35 independent U.S. health insurance companies. The association does not provide bonuses for vaccinating a set number of child patients.
Aggregate Spend is the process used in the United States to aggregate and monitor the total amount spent by healthcare manufacturers on individual healthcare professionals and organizations (HCP/O) through payments, gifts, honoraria, travel and other means. Also often referred to as the Physician Payments Sunshine Act, this initiative is a ...
Change Healthcare is a key player in the U.S. healthcare system that depends heavily on insurance, processing about 50% of medical claims for around 900,000 physicians, 33,000 pharmacies, 5,500 ...
Third-party administrators are prominent players in the health care industry and have the expertise and capability to administer all or a portion of the claims process. They are normally contracted by a health insurer or self-insuring companies to administer services, including claims administration, premium collection, enrollment and other ...
The U.S. health care insurance system relies on private insurance, which covers 200 million Americans, and government-run programs. Americans receive coverage through their employers, government ...
The funds come from the Michigan Health Endowment Fund created in 2013 and requires Blue Cross Blue Shield of Michigan to contribute "up to $1.56 billion over 18 years to a health endowment fund that benefits Michigan residents". [9] In 2023, Blue Cross Blue Shield of Vermont merged into Blue Cross Blue Shield of Michigan. [10]