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  2. Prior authorization - Wikipedia

    en.wikipedia.org/wiki/Prior_authorization

    After a request comes in from a qualified provider, the request will go through the prior authorization process. The process to obtain prior authorization varies from insurer to insurer but typically involves the completion and faxing of a prior authorization form; according to a 2018 report, 88% are either partially or entirely manual. [5]

  3. Utilization management - Wikipedia

    en.wikipedia.org/wiki/Utilization_management

    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 ...

  4. Authorization hold - Wikipedia

    en.wikipedia.org/wiki/Authorization_hold

    Authorization hold (also card authorization, preauthorization, or preauth) is a service offered by credit and debit card providers whereby the provider puts a hold of the amount approved by the cardholder, reducing the balance of available funds until the merchant clears the transaction (also called settlement), after the transaction is completed or aborted, or because the hold expires.

  5. Health Insurance Portability and Accountability Act - Wikipedia

    en.wikipedia.org/wiki/Health_Insurance...

    They are also taught about patients' rights under HIPAA, such as the right to access their health records and request correction. [74] Regular fresher training is recommended to keep healthcare providers up to date with any changes in HIPAA regulations and best practices. This includes updates on new policies, procedures, and any material ...

  6. Vital statistics (government records) - Wikipedia

    en.wikipedia.org/wiki/Vital_statistics...

    A vital statistics system is defined by the United Nations "as the total process of (a) collecting information by civil registration or enumeration on the frequency or occurrence of specified and defined vital events, as well as relevant characteristics of the events themselves and the person or persons concerned, and (b) compiling, processing, analyzing, evaluating, presenting, and ...

  7. Health insurance - Wikipedia

    en.wikipedia.org/wiki/Health_insurance

    Health insurance or medical insurance (also known as medical aid in South Africa) is a type of insurance that covers the whole or a part of the risk of a person incurring medical expenses. As with other types of insurance, risk is shared among many individuals.

  8. Health Maintenance Organization Act of 1973 - Wikipedia

    en.wikipedia.org/wiki/Health_Maintenance...

    The Health Maintenance Organization Act of 1973 (Pub. L. 93-222 codified as 42 U.S.C. §300e) is a United States statute enacted on December 29, 1973. The Health Maintenance Organization Act, informally known as the federal HMO Act, is a federal law that provides for a trial federal program to promote and encourage the development of health maintenance organizations (HMOs).

  9. Wikipedia:Age calculation templates - Wikipedia

    en.wikipedia.org/wiki/Wikipedia:Age_calculation...

    {{Birth date and age2}} – calculates age at a specified date {{Birth based on age as of date}} – used when a reference mentions the age of a person as of the date of the reference's publication {{Birth year and age}} {} {{Death date and age}} {{Death year and age}} {{BirthDeathAge}} – combines the functionality of the above six birth and ...