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Workgroup For Electronic Data Interchange
WEDI, pronounced "wee dee", is a not-for-profit user group in the United States for users of Electronic Data Interchange (EDI) in public and private healthcare. It is sometimes referred to by other names including some or all of the words Workgroup for Electronic Data Interchange. ''By: Hipaasuite'' It was established to provide leadership and guidance to the healthcare industry on how to use and leverage its collective knowledge, expertise and information resources to improve the quality, affordability and availability of healthcare, via forums, conferences and online resources, especially in matters of conformance to EDI standards required by the Health Insurance Portability and Accountability Act, also known as HIPAA which was enacted by the U.S. Congress in 1996. WEDI has regional affiliates in 27 US States and the Virgin Islands. History In November 1991, the Workgroup for Electronic Data Interchange (WEDI) was established in response to the challenge from the Bush admi ...
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United States
The United States of America (U.S.A. or USA), commonly known as the United States (U.S. or US) or America, is a country primarily located in North America. It consists of 50 states, a federal district, five major unincorporated territories, nine Minor Outlying Islands, and 326 Indian reservations. The United States is also in free association with three Pacific Island sovereign states: the Federated States of Micronesia, the Marshall Islands, and the Republic of Palau. It is the world's third-largest country by both land and total area. It shares land borders with Canada to its north and with Mexico to its south and has maritime borders with the Bahamas, Cuba, Russia, and other nations. With a population of over 333 million, it is the most populous country in the Americas and the third most populous in the world. The national capital of the United States is Washington, D.C. and its most populous city and principal financial center is New York City. Paleo-Americ ...
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Pharmacy Benefit Management
In the United States, a pharmacy benefit manager (PBM) is a third-party administrator of prescription drug programs for commercial health plans, self-insured employer plans, Medicare Part D plans, the Federal Employees Health Benefits Program, and state government employee plans. According to the American Pharmacists Association, "PBMs are primarily responsible for developing and maintaining the formulary, contracting with pharmacies, negotiating discounts and rebates with drug manufacturers, and processing and paying prescription drug claims." PBMs operate inside of integrated healthcare systems (e.g., Kaiser Permanente or Veterans Health Administration), as part of retail pharmacies (e.g., CVS Pharmacy or Rite-Aid), and as part of insurance companies (e.g., UnitedHealth Group). As of 2016, PBMs managed pharmacy benefits for 266 million Americans. In 2017, the largest PBMs had higher revenue than the largest pharmaceutical manufacturers, indicating their increasingly large r ...
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Organizations Established In 1991
An organization or organisation (Commonwealth English; see spelling differences), is an entity—such as a company, an institution, or an association—comprising one or more people and having a particular purpose. The word is derived from the Greek word ''organon'', which means tool or instrument, musical instrument, and organ. Types There are a variety of legal types of organizations, including corporations, governments, non-governmental organizations, political organizations, international organizations, armed forces, charities, not-for-profit corporations, partnerships, cooperatives, and educational institutions, etc. A hybrid organization is a body that operates in both the public sector and the private sector simultaneously, fulfilling public duties and developing commercial market activities. A voluntary association is an organization consisting of volunteers. Such organizations may be able to operate without legal formalities, depending on jurisdiction, includin ...
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Medical And Health Organizations Based In The United States
Medicine is the science and practice of caring for a patient, managing the diagnosis, prognosis, prevention, treatment, palliation of their injury or disease, and promoting their health. Medicine encompasses a variety of health care practices evolved to maintain and restore health by the prevention and treatment of illness. Contemporary medicine applies biomedical sciences, biomedical research, genetics, and medical technology to diagnose, treat, and prevent injury and disease, typically through pharmaceuticals or surgery, but also through therapies as diverse as psychotherapy, external splints and traction, medical devices, biologics, and ionizing radiation, amongst others. Medicine has been practiced since prehistoric times, and for most of this time it was an art (an area of skill and knowledge), frequently having connections to the religious and philosophical beliefs of local culture. For example, a medicine man would apply herbs and say prayers for healing, o ...
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National Association Of Insurance Commissioners
The National Association of Insurance Commissioners (NAIC) is the U.S. standard-setting and regulatory support organization created and governed by the chief insurance regulators from the 50 states, the District of Columbia, and five U.S. territories. Mission and function Through the NAIC, state insurance regulators establish standards and best practices, conduct peer review, and coordinate their regulatory oversight. NAIC staff supports these efforts and represents the collective views of state regulators domestically and internationally. NAIC members, together with the central resources of the NAIC, form the national system of state-based insurance regulation in the U.S. The NAIC is an Internal Revenue Code Section 501(c)(3) non-profit organization. The NAIC acts as a forum for the creation of model laws and regulations. Each state decides whether to pass each NAIC model law or regulation, and each state may make changes in the enactment process, but the models are widely, alb ...
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Medicare (United States)
Medicare is a government national health insurance program in the United States, begun in 1965 under the Social Security Administration (SSA) and now administered by the Centers for Medicare and Medicaid Services (CMS). It primarily provides health insurance for Americans aged 65 and older, but also for some younger people with disability status as determined by the SSA, including people with end stage renal disease and amyotrophic lateral sclerosis (ALS or Lou Gehrig's disease). In 2018, according to the 2019 Medicare Trustees Report, Medicare provided health insurance for over 59.9 million individuals—more than 52 million people aged 65 and older and about 8 million younger people. According to annual Medicare Trustees reports and research by the government's MedPAC group, Medicare covers about half of healthcare expenses of those enrolled. Enrollees almost always cover most of the remaining costs by taking additional private insurance and/or by joining a public Part C or P ...
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American Health Care Association
The American Health Care Association (AHCA) is a non-profit federation of affiliated state health organizations that represents more than 14,000 non-profit and for-profit nursing homes, assisted living communities, and facilities for individuals with disabilities. The organization's president and CEO is Mark Parkinson. The National Center for Assisted Living (NCAL) is a part of the AHCA. AHCA was founded in 1949 and is based in Washington, D.C. AHCA/NCAL works with Congress and the federal government to advocate for long-term care services. Membership is open to small and large health care facilities. Employees of member facilities or companies, such as administrators, directors of nursing, certified nursing assistants, and corporate staff, have access to the association’s educational and networking opportunities. Issues Medicare and Medicaid funding In the United States, Medicaid is the primary payer for long-term care. Most Americans (64 percent) who live in a nursing homes ...
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American Association Of Retired Persons
AARP (formerly called the American Association of Retired Persons) is an interest group in the United States focusing on issues affecting those over the age of fifty. The organization said it had more than 38 million members in 2018. The magazine and bulletin it sends to its members are the two largest-circulation publications in the United States. AARP was founded in 1958 by Ethel Percy Andrus, a retired educator from California, and Leonard Davis, who later founded the Colonial Penn Group of insurance companies. It is an influential lobbying group in the United States. AARP sells paid memberships, and markets insurance and other services to its members. History According to the group's official history, AARP evolved from the National Retired Teachers Association (NRTA), which Dr. Ethel Percy Andrus had established in 1947 to promote her philosophy of productive aging, and to promote health insurance for retired teachers. In seeking group insurance coverage for retired teach ...
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Centers For Medicare And Medicaid Services
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 addition to these programs, CMS has other responsibilities, including the administrative simplification standards from the Health Insurance Portability and Accountability Act of 1996 (HIPAA), quality standards in long-term care facilities (more commonly referred to as nursing homes) through its survey and certification process, clinical laboratory quality standards under the Clinical Laboratory Improvement Amendments, and oversight of HealthCare.gov. CMS was previously known as the Health Care Financing Administration (HCFA) until 2001. CMS actively inspects and reports on every nursing home in the United States. This includes maintaini ...
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America’s Health Insurance Plans
AHIP (formerly America's Health Insurance Plans) is an American political advocacy and trade association of health insurance companies that offer coverage through the employer-provided, Medicare Advantage, Medicaid managed care, and individual markets. History AHIP was formed in 2003 by the merger of Health Insurance Association of America and American Association of Health Plans. The association's 2005 television advertisement "Shark Bait" drew criticism for its claim that "lawsuit abuse" by American trial lawyers cost the typical American family $1,200 a year. On August 27, 2009, a spokesman for the association told CNN's ''Lou Dobbs'' program that "every survey shows strong satisfaction for private health insurance," as part of the organization's campaign against health care reform. The non-partisan Politifact watchdog organization found that his words were "half-true." In fact, Politifact said polls have found that often the majority of consumers have varying degrees of sati ...
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American Dental Association
The American Dental Association (ADA) is an American professional association established in 1859 which has more than 161,000 members. Based in the American Dental Association Building in the Near North Side of Chicago, the ADA is the world's largest and oldest national dental association and promotes good oral health to the public while representing the dental profession. The ADA publishes a monthly journal of dental related articles named the ''Journal of the American Dental Association''. Overview The American Dental Association was founded August 3, 1859, at Niagara Falls, New York,American Dental Association
. ''Baltimore Sun''. August 9, 1859. p. 4.
by twenty-six dentists who represented various dental societies in the United States. Today, the ADA has more than 152,000 members, 55 constituent (state-territor ...
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Aetna
Aetna Inc. () is an American managed health care company that sells traditional and consumer directed health care insurance and related services, such as medical, pharmaceutical, dental, behavioral health, long-term care, and disability plans, primarily through employer-paid (fully or partly) insurance and benefit programs, and through Medicare (United States), Medicare. Since November 28, 2018, the company has been a subsidiary of CVS Health. The company's network includes 22.1 million medical members, 12.7 million dental members, 13.1 million pharmacy benefit management services members, 1.2 million Health professional, health-care professionals, over 690,000 primary care doctors and specialists, and over 5,700 hospitals. Aetna is descended from Aetna (Fire) Insurance Company of Hartford, Connecticut. The name of the company is based on Mount Etna, at the time the most active volcano in Europe. History 1800s * ''1819'': Henry Leavitt Ellsworth, Yale University, Yale gra ...
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