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Covered California is the health insurance marketplace in the U.S. state of California established under the federal Patient Protection and Affordable Care Act (ACA). The exchange enables eligible individuals and small businesses to purchase private health insurance coverage at federally subsidized rates. It is administered by an independent ...
In Division 2, the Knox-Keene Health Care Service Plan Act of 1975 in Division 2. Chapter 2.2., 1340 - 1399.864, [13] which is enforced by the California Department of Managed Health Care and regulates most health insurance in California, although some plans are regulated by the California Department of Insurance (CDI) with sometimes similar "companion" statutes in the California Insurance ...
Health insurance. As of 2018, most insured Californians were in plans regulated by the California Department of Managed Health Care (DMHC) with about 60% regulated by either DMHC or the California Department of Insurance (CDI). [1] This dual regulation arose due for historical reasons, and when the DMHC was created in 2000, [2] the California ...
The California Fair Access to Insurance Requirements, or FAIR, Plan was established in 1968 in order to provide insurance coverage to homeowners in high-risk areas, whether that means their ...
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 ...
Major Diagnostic Category. The Major Diagnostic Categories (MDC) are formed by dividing all possible principal diagnoses (from ICD-9-CM) into 25 mutually exclusive diagnosis areas. MDC codes, like diagnosis-related group (DRG) codes, are primarily a claims and administrative data element unique to the United States medical care reimbursement ...
The Centers for Medicare & Medicaid Services ( CMS) is a federal agency within the United States Department of Health and Human Services (HHS) that administers the Medicare program and works in partnership with state governments to administer Medicaid, the Children's Health Insurance Program (CHIP), and health insurance portability standards.
In the United States, health insurance coverage is provided by several public and private sources. During 2019, the U.S. population overall was approximately 330 million, with 59 million people 65 years of age and over covered by the federal Medicare program. The 273 million non-institutionalized persons under age 65 either obtained their ...