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  2. Medical billing - Wikipedia

    en.wikipedia.org/wiki/Medical_billing

    Medical billing is a payment practice within the United States healthcare system. The process involves the systematic submission and processing of healthcare claims for reimbursement. Once the services are provided, the healthcare provider creates a detailed record of the patient's visit, including the diagnoses, procedures performed, and any ...

  3. Revenue cycle management - Wikipedia

    en.wikipedia.org/wiki/Revenue_cycle_management

    Revenue cycle management (RCM) is the process used by healthcare systems in the United States and all over the world to track the revenue from patients, from their initial appointment or encounter with the healthcare system to their final payment of balance. It is a normal part of health administration. The revenue cycle can be defined as, "all ...

  4. Utilization management - Wikipedia

    en.wikipedia.org/wiki/Utilization_management

    Utilization management is "a set of techniques used by or on behalf of purchasers of health care benefits to manage health care costs by influencing patient care decision-making through case-by-case assessments of the appropriateness of care prior to its provision," as defined by the Institute of Medicine [1] Committee on Utilization Management by Third Parties (1989; IOM is now the National ...

  5. Claims and payments integrity, i.e., incorrect billing or fraud, alone accounts for over US$100 billion of the problem. Now, anyone ever having worked in the U.S. healthcare system understands its ...

  6. The founders of Robin Healthcare think doctors need smart ...

    techcrunch.com/2019/09/18/the-founders-of-robin...

    After school, Galan doubled down on his work in claims and billing, launching a company called HonestHealth, where he worked with institutions and companies, like The Robert Wood Johnson ...

  7. Alaffia Health taps AI to detect errors in hospital bills

    techcrunch.com/2022/10/18/alaffia-health-taps-ai...

    Medical expenses are expected to grow by an average of 5.1% from 2021 to 2030, reaching $6.8 trillion, according to the Centers for Medicare and Medicaid Services — and a significant portion of ...

  8. List of open-source health software - Wikipedia

    en.wikipedia.org/wiki/List_of_open-source_health...

    HRHIS is a human resource for health information system for management of human resources for health developed by University of Dar es Salaam college of information and communication technology, Department of Computer Science and Engineering, for Ministry of Health and Social Welfare (Tanzania) and funded by the Japan International Cooperation ...

  9. UnitedHealth unit will start processing $14 billion medical ...

    www.aol.com/news/unitedhealths-change-start...

    Change Healthcare is a key player in the U.S. healthcare system that depends heavily on insurance, processing about 50% of medical claims for around 900,000 physicians, 33,000 pharmacies, 5,500 ...

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