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  2. Medical billing - Wikipedia

    en.wikipedia.org/wiki/Medical_billing

    Claims that are denied or underpaid may require follow-up, appeals, or adjustments by the medical billing department. [5] Accurate medical billing demands proficiency in coding and billing standards, a thorough understanding of insurance policies, and attention to detail to ensure timely and accurate reimbursement.

  3. Evaluation and Management Coding - Wikipedia

    en.wikipedia.org/wiki/Evaluation_and_Management...

    Evaluation and management coding (commonly known as E/M coding or E&M coding) is a medical coding process in support of medical billing.Practicing health care providers in the United States must use E/M coding to be reimbursed by Medicare, Medicaid programs, or private insurance for patient encounters.

  4. Healthcare Common Procedure Coding System - Wikipedia

    en.wikipedia.org/wiki/Healthcare_Common...

    The acronym HCPCS originally stood for HCFA Common Procedure Coding System, a medical billing process used by the Centers for Medicare and Medicaid Services (CMS). Prior to 2001, CMS was known as the Health Care Financing Administration (HCFA).

  5. National Uniform Billing Committee - Wikipedia

    en.wikipedia.org/wiki/National_Uniform_Billing...

    The National Uniform Billing Committee (NUBC) is the governing body for forms and codes use in medical claims billing in the United States for institutional providers like hospitals, nursing homes, hospice, home health agencies, and other providers. The NUBC was formed by the American Hospital Association (AHA) in 1975. [3]

  6. AAPC (healthcare) - Wikipedia

    en.wikipedia.org/wiki/AAPC_(healthcare)

    AAPC provides training, certification, [9] and other services to individuals and organizations across medical coding, medical billing, auditing, compliance, and practice management. These services include networking events such as medical coding seminars and conferences. [10]

  7. Health Insurance Portability and Accountability Act - Wikipedia

    en.wikipedia.org/wiki/Health_Insurance...

    Individuals have the broad right to access their health-related information, including medical records, notes, images, lab results, and insurance and billing information. [47] Explicitly excluded are the private psychotherapy notes of a provider, and information gathered by a provider to defend against a lawsuit.

  8. Direct primary care - Wikipedia

    en.wikipedia.org/wiki/Direct_primary_care

    In the United States, direct primary care (DPC) is a type of primary care billing and payment arrangement made between patients and medical providers, without sending claims to insurance providers. It is an umbrella term , incorporating various health care delivery systems that involve direct financial relationships between patients and health ...

  9. Balance billing - Wikipedia

    en.wikipedia.org/wiki/Balance_billing

    Balance billing, sometimes called surprise billing, is a medical bill from a healthcare provider billing a patient for the difference between the total cost of services being charged and the amount the insurance pays. [1]

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