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  2. Current Procedural Terminology - Wikipedia

    en.wikipedia.org/wiki/Current_Procedural_Terminology

    The Current Procedural Terminology ( CPT) code set is a procedural code set developed by the American Medical Association (AMA). It is maintained by the CPT Editorial Panel. [ 1] The CPT code set describes medical, surgical, and diagnostic services and is designed to communicate uniform information about medical services and procedures among ...

  3. Chargemaster - Wikipedia

    en.wikipedia.org/wiki/Chargemaster

    Chargemasters include thousands of hospital services, medical procedures, equipment fees, drugs, supplies, and diagnostic evaluations such as imaging and blood tests. [ 6] Each item in the chargemaster is assigned a unique identifier code and a set price that are used to generate patient bills. [ 6] Every hospital system maintains its own ...

  4. Medical billing - Wikipedia

    en.wikipedia.org/wiki/Medical_billing

    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 ...

  5. Revenue cycle management - Wikipedia

    en.wikipedia.org/wiki/Revenue_cycle_management

    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.

  6. Physician Payments Sunshine Act - Wikipedia

    en.wikipedia.org/wiki/Physician_Payments...

    The Sunshine Act requires manufacturers of drugs, medical devices, biological and medical supplies covered by the three federal health care programs Medicare, Medicaid, and State Children's Health Insurance Program (SCHIP) to collect and track all financial relationships with physicians and teaching hospitals and to report these data to the Centers for Medicare and Medicaid Services (CMS).

  7. Explanation of benefits - Wikipedia

    en.wikipedia.org/wiki/Explanation_of_benefits

    An explanation of benefits (commonly referred to as an EOB form) is a statement sent by a health insurance company to covered individuals explaining what medical treatments and/or services were paid for on their behalf. [ 1] The EOB is commonly attached to a check or statement of electronic payment. An EOB typically describes: the payee, the ...

  8. Fee-for-service - Wikipedia

    en.wikipedia.org/wiki/Fee-for-service

    Fee-for-service ( FFS) is a payment model where services are unbundled and paid for separately. [ 1] In health care, it gives an incentive for physicians to provide more treatments because payment is dependent on the quantity of care, rather than quality of care. However evidence of the effectiveness of FFS in improving health care quality is ...

  9. Securities Class Action - Wikipedia

    en.wikipedia.org/wiki/Securities_Class_Action

    A securities class action ( SCA ), or securities fraud class action, is a lawsuit filed by investors who bought or sold a company's publicly traded securities within a specific period of time (known as a “class period”) and suffered economic injury as a result of violations of the securities laws . In cases involving misleading statements ...

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