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The X12 834 EDI Enrollment Implementation Format is a standard file format in the United States for electronically exchanging health plan enrollment data between employers and health insurance carriers. The Health Insurance Portability and Accountability Act (HIPAA) requires that all health plans or health insurance carriers accept a standard ...
An explanation of benefits (commonly referred to as an EOB form) is a statement sent by a health insurance company to covered individuals explaining what medical treatments and/or services were paid for on their behalf. [1] The EOB is commonly attached to a check or statement of electronic payment. An EOB typically describes:
ACORD also provided expertise on digital data standards for a collaboration with IBM, ISN, and Marsh to streamline the proof of insurance process with the help of blockchain technology. The partnership is an attempt to eliminate the time- and labor-intensive paper insurance certificates that dominate the global insurance market. [9]
Interactive Forms is a mechanism to add forms to the PDF file format. PDF currently supports two different methods for integrating data and PDF forms. Both formats today coexist in the PDF specification: [38] [53] [54] [55] AcroForms (also known as Acrobat forms), introduced in the PDF 1.2 format specification and included in all later PDF ...
A Health Reimbursement Arrangement, also known as a Health Reimbursement Account (HRA), [1] is a type of US employer-funded health benefit plan that reimburses employees for out-of-pocket medical expenses and, in limited cases, to pay for health insurance plan premiums.
A medical biller then takes the coded information, combined with the patient's insurance details, and forms a claim that is submitted to the payors. [2] Payors evaluate claims by verifying the patient's insurance details, medical necessity of the recommended medical management plan, and adherence to insurance policy guidelines. [4]
National Health Insurance is designed for those who are not eligible for any employment-based health insurance program. The Late-stage Elderly Medical System is designed for people who are age 75 and older. [[[Health insurance#Japan#{{{section}}}| contradictory]]] [41] National Health Insurance is organised on a household basis.
The Federal Employees Health Benefits (FEHB) Program is a system of "managed competition" through which employee health benefits are provided to civilian government employees and annuitants of the United States government. The government contributes 72% of the weighted average premium of all plans, not to exceed 75% of the premium for any one ...