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the service performed—the date of the service, the description and/or insurer's code for the service, the name of the person or place that provided the service, and the name of the patient; the doctor's fee, and what the insurer allows—the amount initially claimed by the doctor or hospital, minus any reductions applied by the insurer
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 ...
Trinxet Dictionary of Legal Abbreviations and Acronyms Series. A Law Reference Collection, 2011, ISBN 1624680003 and ISBN 978-1-62468-000-7; Trinxet, Salvador. Trinxet Reverse Dictionary of Legal Abbreviations and Acronyms, 2011, ISBN 1624680011 and ISBN 978-1-62468-001-4. Raistrick, Donald.
The procedure of developing, maintaining, and monitoring the chargemaster and its pricing scheme often necessitates multiple hospital employees working under the supervision of a "chargemaster coordinator", [10] [11] a "charge master manager", or others in the health care system's operations or administrative support areas frequently called a ...
(2) providing a false statement under oath about a material matter involving a taxpayer or a taxpayer representative; (3) with respect to a taxpayer, or a taxpayer representative, or a fellow employee of the Internal Revenue Service, the violation of any right under the U.S. Constitution or any civil right under various specific federal statutes;
Insurance companies can independently enact and lift this type of moratorium to align with its risk assessment For example, many property insurance carriers issue an insurance moratorium on new ...
Section 514(b)(6)(A)(ii) [14] of ERISA provides that in the case of an employee welfare benefit plan that is a MEWA, any law of any state that regulates insurance may apply to the extent not inconsistent with Title I of ERISA. Accordingly, if a MEWA is self-funded rather than fully insured, the only limitation on the applicability of state ...
The EHB provisions of the ACA was an amendment to the Public Health Service Act. [9] Lavarreda, director of health insurance studies for the UCLA Center for Health Policy Research, explained that before the ACA's passage, U.S. health insurance sector experienced "a race to the bottom, with insurers cutting benefits to lower premiums."