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It originally processed claims for doctors at the Hennepin County Medical Society. [5] UnitedHealthcare Corporation was founded in 1977 to purchase Charter Med and create a network-based health plan for seniors. [6] It became a publicly traded company in 1984 and changed its name to UnitedHealth Group in 1998. [7]
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 ...
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GEHA (Government Employees Health Association) is a self-insured, not-for-profit association providing medical and dental plans to federal employees and retirees and their families through the Federal Employees Health Benefits program and the Federal Employees Dental and Vision Insurance Program (FEDVIP).
Pure IBNR refers to only unreported claims, not any development on reported claims. Incurred but not enough reported (IBNER), in contrast, refers to development on reported claims. For example, when a claim is first reported, a $100 payment might be made, and a $900 case reserve might be established, for a total initial reported amount of $1000.
Since that time, a number of insurance plans have been added or changed. [ 1 ] In 1960, the newly established Federal Employees Health Benefits (FEHB) Act of 1959 provided all Federal employees, annuitants, and eligible family members with the opportunity to voluntarily enroll in a group health benefits program with the government sharing the ...