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A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). The NPI has replaced the Unique Physician Identification Number (UPIN) as the required identifier for Medicare services, and is used by other payers ...
Humana Named Top Payer in athenahealth PayerView Rankings Number one ranking highlights Humana's continuing success in providing industry-leading service to healthcare providers LOUISVILLE, Ky ...
IPAs may also offer care providers an information technology platform offering automation and/ or a connection to an Electronic Health Record (EHR) system. Additionally, IPAs structured as risk-bearing entities can give interested care providers the ability to participate in risk contracts even if they don't have the administrative staff to ...
An electronic remittance advice (ERA) is an electronic data interchange (EDI) version of a medical insurance payment explanation. It provides details about providers' claims payment, and if the claims are denied, it would then contain the required explanations. The explanations include the denial codes and the descriptions, which present at the ...
Health insurance exchanges use electronic data interchange (EDI) to transmit required information between the exchanges and carriers (trading partners), in particular the 834 transaction for enrollment information and the 820 transaction for premium payment. [7] [better source needed]
Humana pulled out of the acquisition after United stock dropped $2.9 billion in value. [9] In 2001, Humana was a cofounder of Avality. [10] In 2005, Humana entered into a business partnership with Virgin Group, offering financial incentives to members for healthy behavior, such as regular exercise. [11]
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Other features of a preferred provider organization generally include utilization review, where representatives of the insurer or administrator review the records of treatments provided to verify that they are appropriate for the condition being treated rather being largely, or solely, being performed to increase the number of people due.