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Benefit Group

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A collection of related healthcare providers and/or organizations and/or type of service, usually based on provider specialty, that negotiate fee schedules/payment contracts with Insurance Carriers, e.g. Pharmacy, Preferred Accommodation, Chiropractors. Benefit Groups are used in Financial Management, Claims and Reimbursement (FICR) to classify Messages, Application Roles and Interactions that are allowed for that group.

This glossary item is based on v3. The wording may have been extended by later edits to provide additional detail.