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Provider credentialing is different from provider enrollment. Provider enrollment is the process of enrolling a provider with insurance payers. The provider must submit a credentialing application that details their training and qualifications to treat patients in their area of specialty.
Health Partners Plans (HPP) is a non-profit hospital-owned health maintenance organization which provides Medicaid and Medicare to central and southeastern Pennsylvania residents. [1] Health Partners Plans has over 262,000 members throughout Pennsylvania and provides healthcare to low income residents in the counties of Bucks , Chester ...
The Pennsylvania Department of Human Services is a state agency in Pennsylvania [2] tasked to provide care and support to vulnerable citizens. With a range of program offices, the department administers various services including eligibility determination, foster care, early childhood development, services for individuals with disabilities, long-term living programs, and management of ...
The deadline to sign up for coverage that would begin January 1, 2014, was December 23, 2013, by which time the problems had largely been fixed. The open enrollment period for 2016 coverage ran from November 1, 2015, to January 31, 2016. [5] State exchanges also have had the same deadlines; their performance has been varied. [6] [7] [8]
Highmark was created in 1977 and in the 1990s by the consolidation of two Pennsylvania licensees of the Blue Cross and Blue Shield Association — Pennsylvania Blue Shield (now Highmark Blue Shield) based in suburban Harrisburg, and Blue Cross of Western Pennsylvania based in downtown Pittsburgh (now Highmark Blue Cross/Blue Shield).
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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 ...
Independence Blue Cross (Independence) is a health insurer based in Philadelphia, Pennsylvania, in the United States. [1] Independence is the largest health insurer in the Philadelphia area, serving people in the region and seven million nationwide.
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