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The NPI is often a common denominator between various healthcare provider identifier numbers, such as CMS Certification Number [10] (CCN; formerly OSCAR number), Employer Identification Number, and PECOS Associate Control ID [11] (PAC ID). With an increasing number of publicly available datasets containing these identifiers, some organizations ...
Unlike PPOs, however, HMOs often require members to select a primary care physician (PCP), a doctor who acts as a gatekeeper to direct access to non-emergency medical services, and are required to first obtain a referral from their PCP in order to be reimbursed for the cost of medical services inside of their network of designated doctors and ...
"Messengers," specialists who are selected to represent individual practices, can be used by IPA members to review and discuss coding and compensation with health insurance companies. These professionals do not collectively bargain and can only do so if the providers have reorganized under a single tax ID number which is not an IPA model.
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In 1996, The Associated Group changed its name to Anthem Insurance Company. [17] In August 1997, Anthem acquired Blue Cross and Blue Shield of Connecticut. [18] It also sold Acordia to management. [19] In 1999, Anthem acquired Blue Cross and Blue Shield of New Hampshire and Blue Cross and Blue Shield of Colorado and Nevada. The acquisitions ...
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To fund FAIR Health, the Attorney General's office secured nearly $100 million from insurers such as Aetna, UnitedHealth Group, and Anthem Inc. [113] Medicare overbilling lawsuit A whistleblower lawsuit filed in 2011 charged UnitedHealth Group's data analytics division with assisting in defrauding Medicare by boosting risk adjustment scores ...
Lawmakers on Thursday rejected a deal backed by President-elect Donald Trump to fund swaths of the U.S. government, upping the risk of a partial shutdown heading into the holiday season.. Trump ...