Search results
Results from the WOW.Com Content Network
The NPI number can be obtained online through the National Plan and Provider Enumeration System (NPPES) pages on CMS's website. [3] Turnaround time for obtaining a number is from 1 to 20 days. NPI numbers can be searched on the CMS website listed in external links 'National Plan and Provider Enumeration System information from CMS'.
[1] [2] The NHCX aims to standardize and simplify the exchange of health claims, making it easier for insurance companies, government schemes, and healthcare providers like hospitals and labs to share data, documents, and images. This system will also make claims processing more transparent and efficient, lowering operational costs. [3] [4]
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.
A complaint system (also known as a conflict management system, internal conflict management system, integrated conflict management system, [1] or dispute resolution system) is a set of procedures used in organizations to address complaints and resolve disputes.
The risk of loss remains with the employer, and not with the TPA. An insurance company may also use a TPA to manage its claims processing, provider networks, utilization review, or membership functions. While some third-party administrators may operate as units of insurance companies, they are often independent.
The Streamlining Claims Processing for Federal Contractor Employees Act (Pub. L. 113–50 (text), 127 Stat. 578, enacted November 21, 2013) was signed into law by President Barack Obama in 2013. It transfers some authority from the Government Accountability Office to the United States Department of Labor in order to streamline the ...
The collapse of claims management company the Accident Group in 2003 increased disquiet with the system. Such companies used aggressive sales techniques and exaggerated claims, profiting from exorbitant commissions on after the event insurance policies. It was estimated that there were about 1,000 such companies in the UK in 2003. [2]
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]