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Administrative data are electronic records of services, including insurance claims and registration systems from hospitals, clinics, medical offices, pharmacies and labs. For example, a measure titled Childhood Immunization Status requires health plans to identify 2-year-old children who have been enrolled for at least a year.
A list of countries by health insurance coverage. The table lists the percentage of the total population covered by total public and primary private health insurance, by government/social health insurance, and by primary private health insurance, including 34 members of Organisation for Economic Co-operation and Development (OECD) member countries.
It is a type of loss ratio, which is a common metric in insurance measuring the percentage of premiums paid out in claims rather than expenses and profit provision. It is calculated by dividing those premiums allocated for fully insured or self-funded health care coverage into the total expenses for inpatient, professional (physicians and other ...
The Affordable Care Act (ACA) established the health insurance rate review program in order to protect consumers from unreasonable rate increases. [1] Through this program, proposed premium increases in the small group and individual markets that are above a threshold amount (ten percent or more, as of February 2014) are reviewed by states or the federal government to determine whether the ...
In order to be clear on the payment of a medical billing claim, the health care provider or medical biller must have complete knowledge of different insurance plans that insurance companies are offering, and the laws and regulations that preside over them. Large insurance companies can have up to 15 different plans contracted with one provider.
A web-based tool that allows users to create customized tables and graphs showing health insurance coverage estimates using U.S. Census surveys between 2008 and 2017. Fronstin, Paul (September 2012). "Sources of Health Insurance and Characteristics of the Uninsured: Analysis of the March 2012 Current Population Survey" (PDF). EBRI Issue Brief ...
All health insurance companies must inform the public when they want to increase health insurance rates for individual or small group policies by an average of 10% or more. This policy is known as 'Rate Review'.
Health insurance costs are a major factor in access to health coverage in the United States. The rising cost of health insurance leads more consumers to go without coverage [1] and increase in insurance cost and accompanying rise in the cost of health care expenses has led health insurers to provide more policies with higher deductibles and other limitations that require the consumer to pay a ...