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Using the 2005 Conversion Factor of $37.90, Medicare paid 1.57 * $37.90 for each 99213 performed, or $59.50. Most specialties charge 200–400% of Medicare rates for their procedures and collect between 50 and 80% of those charges, after contractual adjustments and write-offs. [citation needed]
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 ...
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 ...
The Medicare Sustainable Growth Rate (SGR) was a method used by the Centers for Medicare and Medicaid Services (CMS) in the United States to control spending by Medicare on physician services. [ 1 ] President Barack Obama signed a bill into law on April 16, 2015, the Medicare Access and CHIP Reauthorization Act of 2015 , which ended use of the ...
Premera Blue Cross is a not-for-profit Blue Cross Blue Shield licensed health insurance company based in Mountlake Terrace, Washington, United States. It sells health insurance plans under the Blue Cross license in Washington state except Clark County and under both of the Blue Cross and Blue Shield licenses in Alaska .
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".