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The settlement stems from a class action lawsuit alleging that more than 35 BCBS health insurance plans violated antitrust laws by agreeing not to compete with one another, thereby limiting ...
UnitedHealthcare has agreed to pay a $2.5 million settlement as a resolution to a class action lawsuit that claims the company made unauthorized telemarketing calls in violation of federal law.
Advocate Aurora Health reached a settlement with millions of patients whose ... com or you may mail a paper claim form to Settlement Administrator - 175057, c/o Kroll Settlement Administration LLC ...
Administrative data are electronic records of services, including insurance claims and registration systems from hospitals, clinics, medical offices, pharmacies and labs. For example, a measure titled Childhood Immunization Status requires health plans to identify 2-year-old children who have been enrolled for at least a year.
Denied Claims. These claims are properly filed but do not meet the payor’s criteria for payment. Common reasons include billing for services not covered by the plan, highlighting the importance of verifying insurance coverage during patient registration. Denied claims require investigation to identify the issue and prevent future occurrences.
Insurance companies themselves, as well as self-insuring employers, purchase stop-loss coverage for a premium to protect themselves. [1] In the case of a participant reaching more than the specific (or "individual") stop-loss deductible ($300,000, for example), the insurer will reimburse the insured (the company, not the participant) for the remainder of the claim to be paid over that ...
A California lawmaker introduced a new bill that would force health insurers to disclose denial rates and explain those denials as anger grows over rising costs and uncovered medical care.
Health care fraud includes "snake oil" marketing, health insurance fraud, drug fraud, and medical fraud. Health insurance fraud occurs when a company or an individual defrauds an insurer or government health care program, such as Medicare (United States) or equivalent State programs. The manner in which this is done varies, and persons engaging ...
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