Search results
Results From The WOW.Com Content Network
An electronic data interchange personal identifier, or EDIPI, is a number assigned to a record in the United States Department of Defense's Defense Enrollment and Eligibility Reporting System (DEERS) database. A record in the DEERS database is a person plus personnel category (e.g. contractor, reservist, civilian, active duty, etc.).
Under Tricare Prime, beneficiaries must choose a primary care physician and obtain referrals and authorizations for specialty care. In return for these restrictions, beneficiaries are responsible only for small copayments for each visit (retirees and their families only). There is an annual enrollment fee for Tricare Prime for military retirees ...
In October 2001, TRICARE benefits were extended to retirees and their dependents aged 65 and over. [1] On Oct. 1, 2013, the Defense Health Agency replaced the TRICARE Management Activity. The MHS has a $50+ billion budget and serves approximately 9.5 million beneficiaries. [4]
In 1993, Humana founded Humana Military Healthcare Services (HMHS) as a wholly owned subsidiary. [5] They were awarded their first TRICARE contract in 1995, and began serving military beneficiaries in 1996. [32] From 2004 to 2009, HMHS was the managed care contractor for the Department of Defense Military Health System TRICARE South Region.
Finland was the first country to implement an e-referral system, introduced in the capital city of Helsinki in 1990. The e-referral project was put in place to allow for a more cost-effective way of treating a bigger number of patients, increase productivity and to improve access to healthcare.
In 1996, TriWest Healthcare Alliance was established in order to compete for a U.S. Government contract to manage civilian health care benefits under the newly established TRICARE program within the 16-state TRICARE Central Region, also known as Regions 7 and 8. In 1996, TriWest was awarded the contract for the TRICARE Central Region and began ...
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]
A corporate integrity agreement (CIA) is a document outlining the obligations that a company involved in health care in the United States makes with a federal government agency or a state government as part of a civil settlement.