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Medical billing, a payment process in the United States healthcare system, is the process of reviewing a patient's medical records and using information about their diagnoses and procedures to determine which services are billable and to whom they are billed. [1] This bill is called a claim. [2]
The central feature that makes any system a patient portal is the ability to expose individual patient health information in a secure manner through the Internet. In addition, virtually all patient portals allow patients to interact in some way with health care providers.
The chargemaster may be alternatively referred to as the "charge master", "hospital chargemaster", or the "charge description master" (CDM). [4] [5] It is a comprehensive listing of items billable to a hospital patient or a patient's health insurance provider. [3] [6] It is described as "the central mechanism of the revenue cycle" of a hospital ...
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.
One of the federal laws enacted to safeguard patient's health information (medical record, billing information, treatment plan, etc.) and to guarantee patient's privacy is the Health Insurance Portability and Accountability Act of 1996 or HIPAA. [109] HIPAA gives patients the autonomy and control over their own health records. [109]
IMO's clinical interface terminology, which helps to map diagnostic terminologies to medical concepts and billing codes, was launched in 1995. Products such as Problem (IT) and Procedure (IT) aim to help physicians more easily choose the correct medical term for their cases, which then aids in finding the correct billing code. [ 1 ]
(6005F–6150F) Patient safety (7010F–7025F) Structural measures (9001F–9007F) Non-measure claims-based reporting; CPT II codes are billed in the procedure code field, just as CPT Category I codes are billed. Because CPT II codes are not associated with any relative value, they are billed with a $0.00 billable charge amount. [10]
The revenue cycle can be defined as, "all administrative and clinical functions that contribute to the capture, management, and collection of patient service revenue." [ 1 ] It is a cycle that describes and explains the life cycle of a patient (and subsequent revenue and payments) through a typical healthcare encounter from admission ...