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  2. Prior authorization - Wikipedia

    en.wikipedia.org/wiki/Prior_authorization

    Prior authorization, or preauthorization, [1] is a utilization management process used by some health insurance companies in the United States to determine if they will cover a prescribed procedure, service, or medication.

  3. UnitedHealth Group - Wikipedia

    en.wikipedia.org/wiki/UnitedHealth_Group

    Selling insurance products under UnitedHealthcare, and health care services under the Optum brand, it is the world's ninth-largest company by revenue and the largest health care company by revenue. The company is ranked 8th on the 2024 Fortune Global 500. [4] UnitedHealth Group had a market capitalization of $460.3 billion as of December 20, 2024.

  4. Utilization management - Wikipedia

    en.wikipedia.org/wiki/Utilization_management

    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 ...

  5. Healthcare proxy - Wikipedia

    en.wikipedia.org/wiki/Healthcare_proxy

    Once the healthcare proxy is effective, the agent continues making healthcare decisions as long as the primary individual is legally competent to decide. Moreover, in legal-administrative functions, the healthcare proxy is a legal instrument akin to a "springing" healthcare power of attorney. The proxy must declare the healthcare agent who will ...

  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. SEIU United Healthcare Workers West - Wikipedia

    en.wikipedia.org/wiki/SEIU_United_Healthcare...

    The SEIU United Healthcare Workers West (SEIU-UHW) is a statewide local union of the Service Employees International Union in California in the United States. In 2020, it had 97,000 members, [1] down from nearly 150,000 in 2013. [2] UHW is headquartered in Oakland, California and has offices statewide. UHW is an industrial union representing ...

  8. Power of attorney - Wikipedia

    en.wikipedia.org/wiki/Power_of_attorney

    Related to the health care power of attorney is a separate document known as an advance health care directive, also called a "living will". A living will is a written statement of a person's health care and medical wishes but does not appoint another person to make health care decisions. Depending upon the jurisdiction, a health care power of ...

  9. Health Insurance Portability and Accountability Act - Wikipedia

    en.wikipedia.org/wiki/Health_Insurance...

    EDI Health Care Claim Status Notification (277) is a transaction set that can be used by a healthcare payer or authorized agent to notify a provider, recipient or authorized agent regarding the status of a health care claim or encounter, or to request additional information from the provider regarding a health care claim or encounter. This ...