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  2. National Provider Identifier - Wikipedia

    en.wikipedia.org/wiki/National_Provider_Identifier

    A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). The NPI has replaced the Unique Physician Identification Number (UPIN) as the required identifier for Medicare services, and is used by other payers ...

  3. Medical billing - Wikipedia

    en.wikipedia.org/wiki/Medical_billing

    A medical biller then takes the coded information, combined with the patient's insurance details, and forms a claim that is submitted to the payors. [ 2 ] Payors evaluate claims by verifying the patient's insurance details, medical necessity of the recommended medical management plan, and adherence to insurance policy guidelines. [ 4 ]

  4. Minimum Data Set - Wikipedia

    en.wikipedia.org/wiki/Minimum_Data_Set

    MDS information is transmitted electronically by nursing homes to the MDS database in their respective states. MDS information from the state databases is captured into the national MDS database at Centers for Medicare and Medicaid Services (CMS). Sections of MDS (Minimum Data Set): Identification Information; Hearing, Speech and Vision

  5. Referral (medicine) - Wikipedia

    en.wikipedia.org/wiki/Referral_(medicine)

    In medicine, referral is the transfer of care for a patient from one clinician or clinic to another by request. [ 1 ] [ 2 ] Tertiary care is usually done by referral from primary or secondary medical care personnel.

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  7. Unique physician identification number - Wikipedia

    en.wikipedia.org/wiki/Unique_physician...

    A unique physician identification number (UPIN) was a six-character alpha-numeric identifier used by Medicare to identify doctors in the United States. They were discontinued in June 2007 [ 1 ] and replaced by National Provider Identifier , or NPI numbers.

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