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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 ...
The National Uniform Billing Committee (NUBC) is the governing body for forms and codes use in medical claims billing in the United States for institutional providers like hospitals, nursing homes, hospice, home health agencies, and other providers. The NUBC was formed by the American Hospital Association (AHA) in 1975. [3]
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.
Utilization management is "a set of techniques used by or on behalf of purchasers of health care benefits to manage health care costs by influencing patient care decision-making through case-by-case assessments of the appropriateness of care prior to its provision," as defined by the Institute of Medicine [1] Committee on Utilization Management by Third Parties (1989; IOM is now the National ...
The New Jersey Department of Banking and Insurance (DOBI) is one of 15 principal departments in New Jersey government. The department's mission is to regulate the banking, insurance and real estate industries in a professional and timely manner that protects and educates consumers and promotes the growth, financial stability and efficiency of these industries. [1]
Personal Lines and Commercial Lines Underwriting, General Claims and Medical Services Administration are headquartered there, as are most support services for company operations. NJM has had additional offices in northern New Jersey since the 1950s, but the company's main North Jersey branch has been consolidated in Parsippany since 1996.
Atlantic Health System is one of the largest non-profit health care networks in New Jersey.It employs 18,000 people and more than 4,800 affiliated physicians. The system offers more than 400 sites of care, [1] including six hospitals: Chilton Medical Center, Goryeb Children’s Hospital, Hackettstown Medical Center, Morristown Medical Center, Newton Medical Center and Overlook Medical Center.
In 2006, New Jersey’s Department of Health and Senior Services began licensing private medevac helicopter companies to supplement State Police helicopters. [10] In December 2007, the Public Health Council of New Jersey approved the first state policy in the United States mandating flu vaccines for all New Jersey children, in order for those children to be allowed to attend preschools and day ...