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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]
GuideWell, formally GuideWell Mutual Holding Corporation (holding company for Florida Blue), is a mutual insurance holding company primarily focused on health insurance in Florida. It was created in 2013 by a reorganization initiated by Florida Blue, a member company of the Blue Cross Blue Shield Association . [ 4 ]
Founded in 1948, [26] Arkansas Blue Cross Blue Shield (ABCBS) [27] is an independent licensee of the Blue Cross Blue Shield Association, and the largest healthcare provider in the state. [28] It donated $1.98 million to The Walton College of Business toward founding its Robert L. Shoptaw Master of Healthcare Business Analytics Program. [ 29 ]
The Centers for Medicare & Medicaid Services (CMS) is a federal agency within the United States Department of Health and Human Services (HHS) that administers the Medicare program and works in partnership with state governments to administer Medicaid, the Children's Health Insurance Program (CHIP), and health insurance portability standards.
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Unlike denied claims, rejected claims must be corrected and resubmitted. Failure to address rejected claims can lead to significant revenue loss, making timely rework essential. Step 7: Creating Patient Statements [4] After the payor processes the claim and pays their portion, any remaining balance is billed to the patient in a separate statement.
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The beneficiaries are located in 11 states: Arizona, Georgia, Kansas, New Jersey, New York, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, and Vermont. [ 33 ] [ 34 ] Clover Health created a machine learning software platform called the Clover Assistant to offer care recommendations to primary care physicians and alert them about ...