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  • An organization that integrates financing and management of healthcare with the delivery of healthcare services to an enrolled population. It employs or contracts with an organized system of providers that delivers services, manages the costs of healthcare services, as well as accessibility and quality of care for its enrolled members, and frequently shares financial risk. Managed healthcare plan can do this through a variety of means but usually this involves offering limited choices of providers to its enrollees and negotiating with providers for reimbursement costs. Typically in managed care the third party payer requires second opinions and pre-certification review for patients requiring hospital admission.
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