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UnitedHealthcare (UHC) is an insurance and managed care company with four main divisions: UnitedHealthcare Employer and Individual – provides health benefit plans and services for large national employers and individuals. UnitedHealthcare Medicare and Retirement – provides health and well-being services to individuals age 65 and older. [80]
It is necessary for most users of the CPT code (principally providers of services) to pay license fees for access to the code. [19] In the past, AMA offered a limited search of the CPT manual for personal, non-commercial use on its web site. [20] CPT codes can be looked up on the AAPC (American Academy of Professional Coders) website. [21]
HCPCS includes three levels of codes: Level I consists of the American Medical Association's Current Procedural Terminology (CPT) and is numeric.; Level II codes are alphanumeric and primarily include non-physician services such as ambulance services and prosthetic devices, and represent items and supplies and non-physician services, not covered by CPT-4 codes (Level I).
Stop-loss insurance is a form of reinsurance that insures self-funded plans and their assets. Due to the limited assets at the disposal of an average employer as compared to an insurance company , an employer could easily bankrupt itself if its employees incur a large number of high-dollar claims and the employer is unable to fund them all.
Canadian Classification of Health Interventions (CCI) (used in Canada. Replaced CCP.) [2] Current Dental Terminology (CDT); Healthcare Common Procedure Coding System (including Current Procedural Terminology) (for outpatient use; used in United States)
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]
The original mammogram codes (film based mammograms) are CPT codes (77055, 77056, and 77057), so it would be easy to overlook the increasingly used digital mammogram codes that remain as HCPCS Level 2 codes if one did not know they existed (and possibly under-report mammogram statistics).
Among those who were offered coverage, the study found that 76% received offers at standard premium rates, and 22% were offered higher rates. [48] The frequency of increased premiums also increased with age, so for applicants over 40, roughly half were affected by medical underwriting, either in the form of denial or increased premiums.