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On July 21, 2016, the U.S. Department of Defense awarded Humana Government Business the TRICARE 2017 contract for the East Region, with WPS MVH as a subcontractor. WPS will provide information technology support, claims processing, and customer service functions. The East Region includes 30 states and approximately 6 million TRICARE beneficiaries.
The Wisconsin Department of Health Services (WisDHS) is a governmental agency of the U.S. state of Wisconsin responsible for maintaining public health.It administers a wide range of services in the state and at state institutions, regulates hospitals and care providers, and supervises and consults with local public health agencies.
In the United States, a third-party administrator (TPA) is an organization that processes insurance claims or certain aspects of employee benefit plans for a separate entity. [1] It is also a term used to define organizations within the insurance industry which administer other services such as underwriting and customer service.
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The insurance business was first authorized and regulated in Wisconsin in 1870 (1870 Wisc. Act 56). The original law vested insurance regulation as a power of the Secretary of State of Wisconsin. These powers were transferred to a separate commissioner of insurance by an act of the Wisconsin Legislature in 1878 (1878 Wisc. Act 214).
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General Casualty Insurance was a super-regional property and casualty insurance provider headquartered in Sun Prairie, Wisconsin as of 2006. It operated as a subsidiary of Winterthur U.S. Holdings. It operated as a subsidiary of Winterthur U.S. Holdings.
A medical biller then takes the coded information, combined with the patient's insurance details, and forms a claim that is submitted to the payors. [ 2 ] Payors evaluate claims by verifying the patient's insurance details, medical necessity of the recommended medical management plan, and adherence to insurance policy guidelines. [ 4 ]