What is the difference between the three organization types on the registration application (Provider Group, Third Party Administrator, and Affiliate)?
Provider Group – A physician, hospital, group practice, nursing home, pharmacy or any individual or group of individuals that provide a healthcare service. TPA/Billing SVC – (1) TPA – A firm that performs administrative functions (e.g., Claims processing and membership) for a Self-funded plan or a start-up Managed Care Organization (MCO); (2) Billing SVC – An organization that provides billing and collection services for a provider. Affiliate Providers – An organization, such as Independent Physician Associations (IPA), Medical Services Organizations (MSO) or Provider Health Organizations (PHO), contracted to provide services on behalf of Humana such as credentialing, utilization management, quality management, or claims payment.
Provider Group — A physician, hospital, group practice, nursing home, pharmacy or any individual or group of individuals that provide a healthcare service. TPA/Billing SVC – (1) TPA — A firm that performs administrative functions (e.g., Claims processing and membership) for a Self-funded plan or a start-up Managed Care Organization (MCO); (2) Billing SVC – An organization that provides billing and collection services for a provider. Affiliate Providers — An organization, such as Independent Physician Associations (IPA), Medical Services Organizations (MSO) or Provider Health Organizations (PHO), contracted to provide services on behalf of Humana such as credentialing, utilization management, quality management, or claims payment.
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