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  2. National Provider Identifier - Wikipedia

    en.wikipedia.org/wiki/National_Provider_Identifier

    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 ...

  3. Health Partners Plans - Wikipedia

    en.wikipedia.org/wiki/Health_Partners_Plans

    Health Partners Plans (HPP) is a non-profit hospital-owned health maintenance organization which provides Medicaid and Medicare to central and southeastern Pennsylvania residents. Health Partners Plans has over 262,000 members throughout Pennsylvania and provides healthcare to low income residents in the counties of Bucks , Chester , Delaware ...

  4. Pennie - Wikipedia

    en.wikipedia.org/wiki/Pennie

    agency .pennie .com. Pennie is the official health insurance marketplace in the U.S. state of Pennsylvania established under the federal Patient Protection and Affordable Care Act (ACA). The exchange enables eligible individuals to purchase private health insurance coverage at federally subsidized rates. Launched on September 22, 2020, [1] it ...

  5. Medical billing - Wikipedia

    en.wikipedia.org/wiki/Medical_billing

    Medical billing is a payment practice within the United States healthcare system. The process involves the systematic submission and processing of healthcare claims for reimbursement. Once the services are provided, the healthcare provider creates a detailed record of the patient's visit, including the diagnoses, procedures performed, and any ...

  6. Preferred provider organization - Wikipedia

    en.wikipedia.org/wiki/Preferred_provider...

    A preferred provider organization is a subscription-based medical care arrangement. [ 1] A membership allows a substantial discount below the regularly charged rates of the designated professionals partnered with the organization. Preferred provider organizations themselves earn money by charging an access fee to the insurance company for the ...

  7. Medicare Advantage - Wikipedia

    en.wikipedia.org/wiki/Medicare_Advantage

    Medicare Advantage ( Medicare Part C, MA) is a type of health plan offered by Medicare-approved private companies that must follow rules set by Medicare. Most Medicare Advantage Plans include drug coverage (Part D). Under Part C, Medicare pays a sponsor a fixed payment. The sponsor then pays for the health care expenses of enrollees.

  8. HealthCare.gov - Wikipedia

    en.wikipedia.org/wiki/HealthCare.gov

    Active. HealthCare.gov is a health insurance exchange website operated by the United States federal government under the provisions of the Affordable Care Act or ACA, commonly referred to as "Obamacare", which currently serves the residents of the U.S. states which have opted not to create their own state exchanges. [ 1][better source needed ...

  9. Protected health information - Wikipedia

    en.wikipedia.org/wiki/Protected_health_information

    Protected health information ( PHI) under U.S. law is any information about health status, provision of health care, or payment for health care that is created or collected by a Covered Entity (or a Business Associate of a Covered Entity), and can be linked to a specific individual. This is interpreted rather broadly and includes any part of a ...