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Aetna Inc. (/ ˈ ɛ t n ə / ET-nə) is an American managed health care company that sells traditional and consumer directed health care insurance and related services, such as medical, pharmaceutical, dental, behavioral health, long-term care, and disability plans, primarily through employer-paid (fully or partly) insurance and benefit programs, and through Medicare.
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 ...
A DEA number (DEA Registration Number) is an identifier assigned to a health care provider (such as a physician, physician assistant, nurse practitioner, optometrist, podiatrist, dentist, or veterinarian) by the United States Drug Enforcement Administration allowing them to write prescriptions for controlled substances.
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)
The company was founded in 1986 in Nashville by Phil Bredesen. [3]In August 1998, the company merged with Principal Health Care and moved its headquarters to Bethesda, Maryland.
In the 21st century, commercial payers were increasingly using litigation against providers to combat alleged fraud or abuse. [25] Examples included litigation between Aetna and a group of surgical centers over an out-of-network overbilling scheme and kickbacks for referrals, where Aetna was ultimately awarded $37 million. [25]
The National Practitioner Data Bank (NPDB) is a database operated by the U.S. Department of Health and Human Services that contains medical malpractice payment and adverse action reports on health care professionals.
Mark T. Bertolini (born 1956) is an American businessman who is currently the CEO of Oscar Health, a tech-driven health insurance company located in New York.He was the co-CEO of Bridgewater Associates, one of the world's largest hedge funds, and was previously the CEO of Aetna, a Fortune 50 diversified health care benefits company with over $60 billion in 2015 revenue.