enow.com Web Search

  1. Ads

    related to: valid resource medical definition for health plans

Search results

  1. Results from the WOW.Com Content Network
  2. Relative value unit - Wikipedia

    en.wikipedia.org/wiki/Relative_value_unit

    The services are classified under a nomenclature based on the Current Procedural Terminology (CPT) to which the American Medical Association holds intellectual property rights. [2] Each service in the fee schedule is scored under the resource-based relative value scale (RBRVS) to determine a payment.

  3. Utilization management - Wikipedia

    en.wikipedia.org/wiki/Utilization_management

    Utilization management (UM) or utilization review is the use of managed care techniques such as prior authorization that allow payers, particularly health insurance companies, to manage the cost of health care benefits by assessing its medical appropriateness before it is provided, by using evidence-based criteria or guidelines.

  4. Health insurance - Wikipedia

    en.wikipedia.org/wiki/Health_insurance

    Health insurance or medical insurance (also known as medical aid in South Africa) is a type of insurance that covers the whole or a part of the risk of a person ...

  5. Managed care - Wikipedia

    en.wikipedia.org/wiki/Managed_care

    Nevertheless, according to the trade association America's Health Insurance Plans, 90 percent of insured Americans are now enrolled in plans with some form of managed care. [11] The National Directory of Managed Care Organizations, Sixth Edition profiles more than 5,000 plans, including new consumer-driven health plans and health savings accounts.

  6. Resource-based relative value scale - Wikipedia

    en.wikipedia.org/wiki/Resource-based_relative...

    Resource-based relative value scale (RBRVS) is a schema used to determine how much money medical providers should be paid. It is partially used by Medicare in the United States and by nearly all health maintenance organizations (HMOs).

  7. High-deductible health plan - Wikipedia

    en.wikipedia.org/wiki/High-deductible_health_plan

    A qualifying plan is defined as a health plan that has a minimum deductible not less than some IRS-defined minimum deductible, and a maximum out-of-pocket expense not more than some IRS-defined out-of-pocket maximum, which the Internal Revenue Service may modify each year to reflect change in cost of living. According to the instructions for ...

  8. Medicaid - Wikipedia

    en.wikipedia.org/wiki/Medicaid

    In the United States, Medicaid is a government program that provides health insurance for adults and children with limited income and resources. The program is partially funded and primarily managed by state governments, which also have wide latitude in determining eligibility and benefits, but the federal government sets baseline standards for state Medicaid programs and provides a ...

  9. Medicare (United States) - Wikipedia

    en.wikipedia.org/wiki/Medicare_(United_States)

    Lyndon B. Johnson signing the Medicare amendment (July 30, 1965). Former President Harry S. Truman (seated) and his wife, Bess, are on the far right.. Originally, the name "Medicare" in the United States referred to a program providing medical care for families of people serving in the military as part of the Dependents' Medical Care Act, which was passed in 1956. [7]

  1. Ads

    related to: valid resource medical definition for health plans