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In October 2010, the company acquired Chamberlin Edmonds & Associates, Inc. (CEA), a technology-enabled provider of government program eligibility and enrollment services. [21] In May 2011, the company acquired EquiClaim, a provider of healthcare audit and recovery services for commercial and government payers, from MultiPlan, Inc. [22]
The first function within the revenue cycle is the registration function, which allows the service provider to obtain all of the necessary data needed in order to properly bill an insurance company (per the ANSI 837 5010 standards and requirements). The information that is usually obtained is the patient's full name, date of birth, address ...
In 1995, The Associated Group acquired Community Mutual Insurance, a provider of Blue Cross and Blue Shield insurance plans in Ohio with over 1.9 million policy holders), then set up Anthem Blue Cross and Blue Shield. [16] [17] In 1996, The Associated Group changed its name to Anthem Insurance Company. [17]
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In U.S. health insurance, a preferred provider organization (PPO), sometimes referred to as a participating provider organization or preferred provider option, is a managed care organization of medical doctors, hospitals, and other health care providers who have agreed with an insurer or a third-party administrator to provide health care at ...
Health care providers often receive payments for their services rendered from health insurance providers. In the United States, the Department of Health and Human Services defines a health care provider as any "person or organization who furnishes, bills, or is paid for health care in the normal course of business." [1] [2]
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Medical practice management software (PMS) is a category of healthcare software that deals with the day-to-day operations of a medical practice including veterinarians.Such software frequently allows users to capture patient demographics, schedule appointments, maintain lists of insurance payors, perform billing tasks, and generate reports.