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CDHPs cannot effectively decrease health care costs without the ability for consumers to compare prices prior to use. [31] [32] While cost-estimator tools have become available as part of a broad trend towards consumer-driven health technology in the United States, they often do not use actual negotiated rates and lack quality information. [33]
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 ...
The Healthcare Cost and Utilization Project (HCUP, pronounced "H-Cup") is a family of healthcare databases and related software tools and products from the United States that is developed through a Federal-State-Industry partnership and sponsored by the Agency for Healthcare Research and Quality (AHRQ).
Elevance Health, Inc. is an American for-profit health insurance provider. Prior to June 2022, Elevance Health was named Anthem, Inc. [2] The company's services include medical, pharmaceutical, dental, behavioral health, long-term care, and disability plans through affiliated companies such as Anthem Blue Cross and Blue Shield, Anthem Blue ...
Mercy encourages patients to share their concerns with Anthem by calling the number on the back of their health insurance cards or by calling Anthem 1-800-331-1476.
In the health insurance and the health care industries, FFS occurs if doctors and other health care providers receive a fee for each service such as an office visit, test, procedure, or other health care service. [5] Payments are issued only after the services are provided. FFS is potentially inflationary by raising health care costs. [6]
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