Search results
Results from the WOW.Com Content Network
Payors evaluate claims by verifying the patient's insurance details, medical necessity of the recommended medical management plan, and adherence to insurance policy guidelines. [4] The payor returns the claim back to the medical biller and the biller evaluates how much of the bill the patient owes, after insurance is taken out.
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 Oklahoma Insurance Department is charged with executing all laws relating to insurance and insurance companies doing business in the State. Oklahoma Insurance Commissioner Glen Mulready The current Insurance Commissioner is Glen Mulready who was elected in November 2018 and took the oath of office on January 14, 2019.
It concentrates its operations in Illinois, Montana, New Mexico, Oklahoma, and Texas. HCSC is the fifth-largest health insurer in the US overall and employs more than 23,000 people. As of 2019, it was noted to be the third-largest commercial health insurer in the United States [1] It serves nearly 16 million members.
Last week, Humana Inc (NYSE:HUM) agreed to pay $90 million to the federal government to settle a whistleblower lawsuit alleging fraudulent Medicare Part D bids. The lawsuit, filed by Phillips ...
Get AOL Mail for FREE! Manage your email like never before with travel, photo & document views. Personalize your inbox with themes & tabs. You've Got Mail!
U.S. President-elect Donald Trump refused on Tuesday to rule out using military or economic action to pursue acquisition of the Panama Canal and Greenland, part of a broader expansionist agenda he ...
In 1982 through the merger of the Insurance Company of North America (INA) founded in 1792 and Connecticut General (CG) founded in 1865 came together to become CIGNA. Also in 1929 Dr. Michael Shadid created a health plan in Elk City, Oklahoma in which farmers bought shares for $50 to raise the money to build a hospital. The medical community ...