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nH Predict is a computer program developed by naviHealth that implements an algorithm that has allegedly been used by health insurance companies including United Healthcare and Humana [1] [2] to automatically deny coverage to patients. [3] [4] [5] It is reported to work by cross-correlating patient health records with those of other patients. [6]
UnitedHealthcare (UHC) is an insurance and managed care company with four main divisions: UnitedHealthcare Employer and Individual – provides health benefit plans and services for large national employers and individuals. UnitedHealthcare Medicare and Retirement – provides health and well-being services to individuals age 65 and older. [80]
The X12 834 EDI Enrollment Implementation Format is a standard file format in the United States for electronically exchanging health plan enrollment data between employers and health insurance carriers.
Feb. 2014: Optum purchases a majority stake in Audax Health Solutions, a patient engagement [clarification needed] company. Audax is later rebranded as Rally Health. April 2015: Optum acquires MedExpress, an urgent care and preventative services company. [9] July 2015: Catamaran, a pharmacy benefit manager, joins OptumRx. [3]
View this interactive chart on Fortune.com Premiums for Medicare Part C Medicare Part C plans, also known as Medicare Advantage plans , are an alternative to Medicare Parts A and B and often ...
The first move towards a national health insurance system was launched in Germany in 1883, with the Sickness Insurance Law. Industrial employers were mandated to provide injury and illness insurance for their low-wage workers, and the system was funded and administered by employees and employers through "sick funds", which were drawn from deductions in workers' wages and from employers ...
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by electronic patient record systems to identify treating health care providers in patient medical records; by the Department of Health and Human Services to cross reference health care providers in fraud and abuse files and other program integrity files; for any other lawful activity requiring individual identification. [2]