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UnitedHealthcare (UHC) is an insurance and managed care company with four main divisions: UnitedHealthcare Employer and Individual – provides health benefit plans and services for large national employers and individuals. UnitedHealthcare Medicare and Retirement – provides health and well-being services to individuals age 65 and older. [80]
The UHC Foundation is a 501(c)(3) organization that commits to providing quality health supportive services with a variety of resources to enhance the well-being of rural San Joaquin Valley communities. In 1971, UHC originated in the farm working communities where residents expressed the need to have improved access to healthcare.
Optum serves employers, government agencies, health plans, life science companies, care providers and individuals and families offering products in data and analytics, pharmacy care services, health care operations and delivery, population health management and advisory services. [7]
As a condition of participation, UnitedHealthcare requires that providers notify them of changes, but also has a Professional Verification Outreach program to proactively request information from providers. [19] However, providers are burdened by having to maintain their information with multiple networks (e.g., competitors to UnitedHealthcare).
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CRISP integrates health information from hospitals, laboratories, pharmacies, and other healthcare entities, enabling providers to access real-time patient data. It focuses on ensuring that providers have access to the information they need to make informed clinical decisions. [19] Key Features: Real-time health data sharing.
Between 2013 and 2017, healthcare providers created 11 new integrated delivery systems from joint ventures with insurance companies. [6] Some insurance companies have invested in primary care, particularly UnitedHealthcare, which runs a provider subsidiary, OptumCare. [7]
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 ...