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UnitedHealthcare (UHC) is an insurance and managed care company with four main divisions: UnitedHealthcare Employer and Individual – provides health benefit plans and services for large national employers and individuals. UnitedHealthcare Medicare and Retirement – provides health and well-being services to individuals age 65 and older. [76]
In the United States, health insurance providers often hire an outside company to handle price negotiations, insurance claims, and distribution of prescription drugs. Providers which use such pharmacy benefit managers include commercial health plans , self-insured employer plans, Medicare Part D plans , the Federal Employees Health Benefits ...
Golden Rule Insurance Company was a provider of health insurance based in Indianapolis with operations in 40 U.S. states and the District of Columbia. It was acquired by UnitedHealth Group in November 2003.
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 ...
Change Healthcare was established in 2007 and based in Brentwood, Tennessee. [5] The company provided healthcare consumer engagement [clarification needed] and health plan cost transparency tools to health plans and large, self-insured employers, [6] across the United States.
The same memorandum said that 212,800 claims had been refused payment due to pre-existing conditions and that insurance firms had business plans to limit money paid based on these pre-existing conditions. These persons who might not have received insurance under previous industry practices are guaranteed insurance coverage under the ACA.
The payer is a healthcare organization that pays claims, administers insurance or benefit or product. Examples of payers include an insurance company, healthcare professional (HMO), preferred provider organization (PPO), government agency (Medicaid, Medicare etc.) or any organization that may be contracted by one of these former groups.
HealthMarkets Insurance Agency, Inc., formerly known as Insphere Insurance Solutions, Inc., is licensed as an insurance agency in all 50 states. The company offers individual policies as well as life insurance, supplemental insurance, Medicare, dental insurance, vision insurance, and long-term plans from national and regional carriers through a ...