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The EDI Health Care Claim Payment/Advice Transaction Set (835) can be used to make a payment, send an Explanation of Benefits (EOB), send an Explanation of Payments (EOP) remittance advice, or make a payment and send an EOP remittance advice only from a health insurer to a health care provider either directly or via a financial institution.
An explanation of benefits (commonly referred to as an EOB form) is a statement sent by a health insurance company to covered individuals explaining what medical treatments and/or services were paid for on their behalf. [1] The EOB is commonly attached to a check or statement of electronic payment. An EOB typically describes:
A public service mutual, by definition, has a significant degree of employee ownership, influence or control, but most public service mutuals identify themselves as social enterprises rather than employee owned. [11] A worker cooperative is a cooperative owned and self-managed by its workers. It is a type of employee owned company that operates ...
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.
CVS Health's Caremark, Cigna's Express Scripts and UnitedHealth Group's Optum control the majority of the U.S. pharmacy benefit market, with their parent companies also operating health insurance ...
This is a list of abbreviations used in law and legal documents. It is common practice in legal documents to cite other publications by using standard abbreviations for the title of each source.
1 Promoting Healthy Choices: Information vs. Convenience Jessica Wisdom, Julie S. Downs and George Loewenstein Contact Information: We thank the USDA Economic Research Service and the Center for Behavioral Decision
AR, meaning Action Required. The recipient is informed that they are being given a task. CFI, meaning Copied For Information; COB, meaning Close Of Business (end of work day). Implying that something should happen by the end of the typical work shift. COP or EOP, meaning Close Of Play / End Of Play.