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  2. Wellmark Blue Cross Blue Shield - Wikipedia

    en.wikipedia.org/wiki/Wellmark_Blue_Cross_Blue...

    Wellmark is headquartered in downtown Des Moines and Sioux Falls. It has 1707 employees in Iowa and 171 in South Dakota. [5] It consists of Wellmark Blue Cross and Blue Shield of Iowa, Wellmark of South Dakota, Inc. (doing business as Wellmark Blue Cross and Blue Shield of South Dakota) and Wellmark Health Plan of Iowa, Inc. [5] The Wellmark Foundation is a private foundation to support health ...

  3. Centene Corporation - Wikipedia

    en.wikipedia.org/wiki/Centene_Corporation

    In 2011, the firm formed Centurion, a provider of correctional health care services, as a joint venture with MHM Services. [6] In 2018, it acquired MHM Services, including its stake in Centurion. [6] Centene began offering state-run Medicaid programs through Affordable Care Act exchanges in 2014. [7]

  4. WellCare - Wikipedia

    en.wikipedia.org/wiki/Wellcare

    WellCare began operations in 1985 in Tampa, Florida as a Medicaid provider for the State of Florida. [5] In 1992, Kiran Patel, a cardiologist and entrepreneur, purchased the company. [6] [7] In 2002, Patel sold it to a New York investment group led by George Soros and Todd Farha. [7] Also in 2002, Todd Farha joined the company as CEO. [8] [9]

  5. George M. Rapier III - Wikipedia

    en.wikipedia.org/wiki/George_M._Rapier_III

    George M. Rapier III is an American businessman, and chairman and CEO of WellMed Medical Management, Inc., a diversified healthcare company and Physicians Health Choice, a physician-owned Medicare Advantage Organization contracted with the Centers for Medicare and Medicaid Services (CMS).

  6. Medical billing - Wikipedia

    en.wikipedia.org/wiki/Medical_billing

    Medical billing, a payment process in the United States healthcare system, is the process of reviewing a patient's medical records and using information about their diagnoses and procedures to determine which services are billable and to whom they are billed.

  7. UnitedHealth Group - Wikipedia

    en.wikipedia.org/wiki/UnitedHealth_Group

    Cuomo said this inappropriately allowed health insurance companies to deny a portion of provider claims, thereby pushing costs down to members. [ 113 ] On January 13, 2009, Ingenix announced an agreement with the New York State attorney settling the probe into the independence of the health pricing database.

  8. National Provider Identifier - Wikipedia

    en.wikipedia.org/wiki/National_Provider_Identifier

    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 ...

  9. Third-party administrator - Wikipedia

    en.wikipedia.org/wiki/Third-party_administrator

    This term is also now commonly used in commercial general liability (CGL) policies or so called "casualty" business. In these instances, the liability policies are written with a large (in excess of $50,000) self-insured retention (SIR) that operates somewhat like a deductible, but rather than being paid at the end of a claim (when a loss payment is made to a claimant), the money is paid up ...