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  2. ANSI 834 Enrollment Implementation Format - Wikipedia

    en.wikipedia.org/wiki/ANSI_834_Enrollment...

    The 834 is used to transfer enrollment information from the sponsor of the insurance coverage, benefits, or policy to a payer. The format attempts to meet the health care industry's specific need for the initial enrollment and subsequent maintenance of individuals who are enrolled in insurance products.

  3. Enhanced Direct Enrollment - Wikipedia

    en.wikipedia.org/wiki/Enhanced_Direct_Enrollment

    Enhanced Direct Enrollment (EDE) is a provision in the United States that allows certain private entities, including insurance carriers and web-brokers, to directly enroll consumers in Qualified Health Plans through the Health Insurance Marketplace without redirecting consumers to Healthcare.gov. Approved EDE partners may access a suite of APIs which allow them to directly submit and update ...

  4. Credentialing - Wikipedia

    en.wikipedia.org/wiki/Credentialing

    The Centers for Medicare and Medicaid Services (CMS) Conditions of Participation (CoPs) allow an originating site facility to use proxy credentialing when telemedicine services are provided by a practitioner affiliated with and credentialed by either a Medicare-participating distant site hospital or an entity that qualifies as a distant site telemedicine entity; and when there is a written ...

  5. Centers for Medicare & Medicaid Services - Wikipedia

    en.wikipedia.org/wiki/Centers_for_Medicare...

    HCFA was renamed the Centers for Medicare and Medicaid Services on July 1, 2001. [9] [11] In 2013, a report by the inspector general found that CMS had paid $23 million in benefits to deceased beneficiaries in 2011. [12] In April 2014, CMS released raw claims data from 2012 that gave a look into what types of doctors billed Medicare the most. [13]

  6. List of healthcare accreditation organizations in the United ...

    en.wikipedia.org/wiki/List_of_healthcare...

    A number have deeming power for Medicare and Medicaid. American Association for Accreditation of Ambulatory Surgery Facilities [2] (AAAASF) Accreditation Association for Ambulatory Health Care (AAAHC) Accreditation Commission for Health Care (ACHC) American Board for Certification in Orthotics, Prosthetics & Pedorthics (ABC)

  7. Physician Quality Reporting System - Wikipedia

    en.wikipedia.org/wiki/Physician_Quality...

    In 2006 the Tax Relief and Health Care Act (TRHCA) included a provision for a 1.5% incentive payment to eligible providers who successfully submitted quality data to CMS. This provision included a cap on payments. The 2007 Medicare, Medicaid, and SCHIP Extension Act extended the program through 2008 and 2009. It also removed the TRHCA payment cap.

  8. Hospital accreditation - Wikipedia

    en.wikipedia.org/wiki/Hospital_accreditation

    Accreditation Canada accredited its first organization internationally in 1967 in Bermuda. [8] In 2010, Accreditation Canada International (ACI) was created to provide accreditation to hospitals, clinics, primary care centers and health systems. [9] Acreditas Global (formerly AAAHC International) has been present in Peru since 2012 and Costa ...

  9. Center for Medicare and Medicaid Innovation - Wikipedia

    en.wikipedia.org/wiki/Center_for_Medicare_and...

    The Center for Medicare and Medicaid Innovation (CMMI; also known as the CMS Innovation Center) is an organization of the United States government under the Centers for Medicare and Medicaid Services (CMS). [1] It was created by the Patient Protection and Affordable Care Act, the 2010 U.S. health care reform legislation.

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