Question

Subject/Class Introduction to Healthcare Insurance coding billing and reimbursement

Commercial insurance ranges from individual health coverage to automobile liability coverage. All commercial policies have similarities and differences, and there are critical areas to address in billing for each type.

Tasks:

Describe at least three commercial insurance programs.

Provide the major features of each program.

Discuss how these programs differ from each other.

Briefly describe how to bill for each program.

Please cite references

Answer 1

1.) Anthem: founded in 1940. Till 2014 it was known with the name, Wellpoint, Inc. It is an american company and is one of the largest among the health insurance in terms of profit making. It was associated with amny controversies such as policy cancellations and data breach.

2.) Aetna: It was founded in 1853, american based company mainly sells consumer directed health care insurance plans such as medical, pharmaceutical, dental, long term care etc. It went global after acquiring UK based InterGlobal group.

3.) Humana: A for-profit company founded in 1961, till1983 it involved nursing homes and hospitals. From 1983 to present it is providing health insurances. It is presently the third largest health insurance company in US.

Differences	Anthem	Aetna	Humana
Insurance	Health, Vision, Dental insurance	consumer directed health care	long term care provider
Net revenue	$ 89.1 B	$ 63 B	$ 54.3 B