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  2. Medical billing - Wikipedia

    en.wikipedia.org/wiki/Medical_billing

    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]

  3. Independent medical review - Wikipedia

    en.wikipedia.org/wiki/Independent_medical_review

    An independent medical review (IMR) is the process where physicians review medical cases in order to provide claims determinations for health insurance payers, workers compensation insurance payers or disability insurance payers. Peer review also is used in order to define the review of sentinel events in a hospital environment for quality ...

  4. Utilization management - Wikipedia

    en.wikipedia.org/wiki/Utilization_management

    Utilization management is "a set of techniques used by or on behalf of purchasers of health care benefits to manage health care costs by influencing patient care decision-making through case-by-case assessments of the appropriateness of care prior to its provision," as defined by the Institute of Medicine [1] Committee on Utilization Management by Third Parties (1989; IOM is now the National ...

  5. UnitedHealth unit will start processing $14 billion medical ...

    www.aol.com/news/unitedhealths-change-start...

    Change Healthcare is a key player in the U.S. healthcare system that depends heavily on insurance, processing about 50% of medical claims for around 900,000 physicians, 33,000 pharmacies, 5,500 ...

  6. Prior authorization - Wikipedia

    en.wikipedia.org/wiki/Prior_authorization

    After a request comes in from a qualified provider, the request will go through the prior authorization process. The process to obtain prior authorization varies from insurer to insurer but typically involves the completion and faxing of a prior authorization form; according to a 2018 report, 88% are either partially or entirely manual.

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  9. Feeling so tired all the time? Iron deficiency might be the ...

    www.aol.com/lifestyle/feeling-tired-time-iron...

    From the outset, correcting an iron deficiency may seem small, but it can make a world of a difference in helping you feel empowered and in control of your health. Restoring iron to your body can ...