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  2. Quest Diagnostics - Wikipedia

    en.wikipedia.org/wiki/Quest_Diagnostics

    In May 2011, Quest paid $241 million to the state of California to settle a False Claims Act case that alleged the company had overcharged Medi-Cal, the state's Medicaid program, and provided illegal kickbacks as incentives for healthcare providers to use Quest labs. [52] In 2018, Quest Diagnostics was among a number of US based labs linked to ...

  3. Capitation (healthcare) - Wikipedia

    en.wikipedia.org/wiki/Capitation_(healthcare)

    Provider revenues are fixed, and each enrolled patient makes a claim against the full resources of the provider. In exchange for the fixed payment, physicians essentially become the enrolled clients' insurers, who resolve their patients' claims at the point of care and assume the responsibility for their unknown future health care costs.

  4. Top earners at Quest Diagnostics to pay higher insurance ...

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  5. Medical billing - Wikipedia

    en.wikipedia.org/wiki/Medical_billing

    In order to be clear on the payment of a medical billing claim, the health care provider or medical biller must have complete knowledge of different insurance plans that insurance companies are offering, and the laws and regulations that preside over them. Large insurance companies can have up to 15 different plans contracted with one provider.

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  7. Medical laboratory - Wikipedia

    en.wikipedia.org/wiki/Medical_laboratory

    In 2016, an estimated 60% of revenue was done by hospital labs, with 25% done by two independent companies (LabCorp and Quest). [24] Hospital labs may also outsource their lab, known as outreach, to run tests; however, health insurers may pay the hospitals more than they would pay a laboratory company for the same test, but as of 2016, the ...

  8. Pay for performance (healthcare) - Wikipedia

    en.wikipedia.org/wiki/Pay_for_performance...

    Pay for performance programs often target patients with serious and complex illnesses; such patients commonly interact with multiple healthcare providers and facilities. However, pilot programs now underway focus on simple indicators such as improvement in lab values or use of emergency services, avoiding areas of complexity such as multiple ...

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