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By 2010, the company was the third largest Medicaid HMO in the country, with $2.5 billion in revenue and 800,000 members across Ohio and Michigan. [12] In 2010, CareSource announced expansion of its provider network in Southeastern Ohio through a partnership with Quality Care Partners (QCP), a physician-hospital organization (PHO). [13]
In the US a certificate of medical necessity is a document required by Centers for Medicare and Medicaid Services to substantiate in detail the medical necessity of an item of durable medical equipment or a service to a Medicare beneficiary. [1]
The Centers for Medicare & Medicaid Services (CMS) is a federal agency within the United States Department of Health and Human Services (HHS) that administers the Medicare program and works in partnership with state governments to administer Medicaid, the Children's Health Insurance Program (CHIP), and health insurance portability standards.
Medicaid is the largest source of funding for medical and health-related services for people with low income in the United States, providing free health insurance to 85 million low-income and disabled people as of 2022; [3] in 2019, the program paid for half of all U.S. births. [4]
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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Two years after the merger, the new company joined Blue Cross and Blue Shield of Northwest Ohio to form Blue Cross and Blue Shield of Ohio. [8] In 1997, the company left the Blue Cross/Blue Shield Association and re-claimed the name of one of its predecessors, becoming the present day Medical Mutual of Ohio. [9]