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  2. Medical billing - Wikipedia

    en.wikipedia.org/wiki/Medical_billing

    On the other hand, medical billing involves using these codes to create and submit claims to insurance companies and patients. In essence, medical coders lay the foundation by providing the necessary codes, while medical billers use those codes to process payments and manage patient accounts.

  3. Explanation of benefits - Wikipedia

    en.wikipedia.org/wiki/Explanation_of_benefits

    adjustment reasons, adjustment codes; EOB documents are protected health information. Electronic EOB documents are called edi 835 5010 files. [2] There will normally also be at least a brief explanation of any claims that were denied, along with a point to start an appeal. [3]

  4. 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]

  5. Healthcare Common Procedure Coding System - Wikipedia

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

    Such coding is necessary for Medicare, Medicaid, and other health insurance programs to ensure that insurance claims are processed in an orderly and consistent manner. Initially, use of the codes was voluntary, but with the implementation of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) use of the HCPCS for ...

  6. Confessions of an insurance claims adjuster - AOL

    www.aol.com/finance/confessions-insurance-claims...

    What can I do if I disagree with the claims adjuster’s decision? Sometimes, an insured disagrees with an adjuster’s decision or the claim payout amount. In general, insurance adjusters are ...

  7. Adjustment (law) - Wikipedia

    en.wikipedia.org/wiki/Adjustment_(law)

    Adjustment of claims is not confined to claims against insurance companies. An allowance made by a creditor, particularly a storekeeper, in response to a complaint by the debtor respecting the accuracy of the account or other claim, or a reduction in the claim or account made to induce a prompt payment, is in a proper sense an adjustment.

  8. Adjustment clause - Wikipedia

    en.wikipedia.org/wiki/Adjustment_clause

    Adjustment of claims is not confined to claims against insurance companies. An allowance made by a creditor, particularly a storekeeper, in response to a complaint by the debtor respecting the accuracy of the account or other claim, or a reduction in the claim or account made to induce a prompt payment, is in a proper sense an adjustment. [2]

  9. Current Procedural Terminology - Wikipedia

    en.wikipedia.org/wiki/Current_Procedural_Terminology

    The CPT code revisions in 2013 were part of a periodic five-year review of codes. Some psychotherapy codes changed numbers, for example 90806 changed to 90834 for individual psychotherapy of a similar duration. Add-on codes were created for the complexity of communication about procedures.