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The RUC examines each new code to determine a relative value by comparing the physician work of the new code to the physician work involved in existing codes. The practice expense, determined by the Practice Expense Review Committee, consists of the direct expenses related to supplies and non-physician labor used in providing the service, and ...
The POS is based on a managed care foundation—lower medical costs in exchange for more limited choice. But POS health insurance does differ from other managed care plans. Enrollees in a POS plan are required to choose a primary care physician (PCP) from within the health care network; this PCP becomes their "point of service". The PCP may ...
In U.S. health insurance, a preferred provider organization (PPO), sometimes referred to as a participating provider organization or preferred provider option, is a managed care organization of medical doctors, hospitals, and other health care providers who have agreed with an insurer or a third-party administrator to provide health care at ...
Usual, customary, and reasonable (UCR) is an American method of generating health care prices, [1] described as "more or less whatever doctors decided to charge". [2] According to Steven Schroeder , Wilbur Cohen inserted UCR into the Social Security Act of 1965 "in an unsuccessful attempt to placate the American Medical Association ". [ 3 ]
Founded in 1948, [26] Arkansas Blue Cross Blue Shield (ABCBS) [27] is an independent licensee of the Blue Cross Blue Shield Association, and the largest healthcare provider in the state. [28] It donated $1.98 million to The Walton College of Business toward founding its Robert L. Shoptaw Master of Healthcare Business Analytics Program. [ 29 ]
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 ...
BCBS 239 is the Basel Committee on Banking Supervision's standard number 239. The subject title of the standard is: "Principles for effective risk data aggregation and risk reporting". The subject title of the standard is: "Principles for effective risk data aggregation and risk reporting".
Carelon Behavioral Health, formerly known as Beacon Health Options, is a behavioral health company based in Boston, Massachusetts.. On Jun. 6, 2019, Anthem, Inc. (now Elevance Health) announced that it had entered into a definitive agreement to acquire Beacon Health Options. [1]