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Harvard Pilgrim Health Care is a non-profit health services company based in Canton, Massachusetts serving the New England region of the United States. On August 14, 2019, the boards of Harvard Pilgrim Health Care and Tufts Health Plan announced plans for the two insurers to merge their organizations into a new company.
It completed a merger with Harvard Pilgrim Health Care on January 1, 2021, making the then unnamed company the second-largest health insurer in Massachusetts. [2] [3] The merger had been announced on August 14, 2019; the combined company serves 2.4 million members in Massachusetts, Maine, Connecticut, New Hampshire, and Rhode Island.
Harvard Pilgrim is an insurance company that sells Medicare Advantage plans and Medicare supplement (Medigap) plans. It sells these plans to people who live in Massachusetts, Maine, and New Hampshire.
Oct. 18—"IMPORTANT NOTICE: Your Medicare plan won't be offered in 2025." An estimated 10,000 New Hampshire seniors got that unsettling message in letters sent out earlier this month by Harvard ...
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]
Medi-Cal was created in 1965 by the California Medical Assistance Program a few months after the national legislation was passed. [2] Approximately 15.28 million people were enrolled in Medi-Cal as of September 2022, [3] or about 40% of California's population; in most counties, more than half of eligible residents were enrolled as of 2020. [4]
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The California Department of Health Care Services (DHCS) is a department within the California Health and Human Services Agency that finances and administers a number of individual health care service delivery programs, including Medi-Cal, which provides health care services to low-income people.