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  2. Preferred provider organization - Wikipedia

    en.wikipedia.org/wiki/Preferred_provider...

    In U.S. health insurance, a preferred provider organization (PPO), sometimes referred to as a participating provider organization or preferred provider option, is a managed care organization of medical doctors, hospitals, and other health care providers who have agreed with an insurer or a third-party administrator to provide health care at ...

  3. Elevance Health - Wikipedia

    en.wikipedia.org/wiki/Elevance_Health

    Elevance Health, Inc. is an American for-profit health insurance provider. Prior to June 2022, Elevance Health was named Anthem, Inc . [ 2 ] The company's services include medical, pharmaceutical, dental, behavioral health, long-term care, and disability plans through affiliated companies such as Anthem Blue Cross and Blue Shield, Anthem Blue ...

  4. Exclusive provider organization - Wikipedia

    en.wikipedia.org/wiki/Exclusive_provider...

    In the United States, an exclusive provider organization (EPO) is a hybrid health insurance plan in which a primary care provider is not necessary, but health care providers must be seen within a predetermined network. Out-of-network care is not provided, and visits require pre-authorization.

  5. Integrated delivery system - Wikipedia

    en.wikipedia.org/wiki/Integrated_delivery_system

    Five factors that can be used to assess the advancement level of a particular IDN include provider alignment, continuum of care, regional presence, clinical integration, and reimbursement. [5] Between 2013 and 2017, healthcare providers created 11 new integrated delivery systems from joint ventures with insurance companies. [6]

  6. Health insurance in the United States - Wikipedia

    en.wikipedia.org/wiki/Health_insurance_in_the...

    Healthcare in the United States Government health programs Federal Employees Health Benefits Program (FEHBP) Indian Health Service (IHS) Medicaid / State Health Insurance Assistance Program (SHIP) Medicare Prescription Assistance (SPAP) Military Health System (MHS) / Tricare Children's Health Insurance Program (CHIP) Program of All-Inclusive Care for the Elderly (PACE) Veterans Health ...

  7. Health care provider - Wikipedia

    en.wikipedia.org/wiki/Health_care_provider

    Health care providers often receive payments for their services rendered from health insurance providers. In the United States, the Department of Health and Human Services defines a health care provider as any "person or organization who furnishes, bills, or is paid for health care in the normal course of business." [1] [2]

  8. National Provider Identifier - Wikipedia

    en.wikipedia.org/wiki/National_Provider_Identifier

    by health care clearinghouses in their internal files to create and process standard transactions and to communicate with health care providers and health plans; by electronic patient record systems to identify treating health care providers in patient medical records; by the Department of Health and Human Services to cross reference health ...

  9. Health insurance marketplace - Wikipedia

    en.wikipedia.org/wiki/Health_insurance_marketplace

    As of April 19, 2014, 8.02 million people had signed up through the health insurance marketplaces. An additional 4.8 million joined Medicaid. [3] Enrollment for 2015 began on November 15, 2014, and ended on December 15, 2014. [4] As of April 14, 2020, 11.41 million people had signed up through the health insurance marketplaces. [5]