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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 acronym HCPCS originally stood for HCFA Common Procedure Coding System, a medical billing process used by the Centers for Medicare and Medicaid Services (CMS). Prior to 2001, CMS was known as the Health Care Financing Administration (HCFA).
The Master of Health Administration, Master of Healthcare Administration (MHA), or Master of Health Management (MHM), is a master's-level professional degree granted to students who complete a course of study in the knowledge and competencies needed for careers in health administration, involving the management of hospitals and other health services organizations, as well as public health ...
While some researchers vary on what services they define as "administrative," the U.S. spent anywhere from 7% to 34% of its health care dollars on administration as recently as 2022—and no ...
Registered health information administrator (RHIA), previously known as registered record administrator, is a professional certification administered by the American Health Information Management Association (AHIMA) in the United States. Passing the exam results in certification for health information management.
Clinical documentation improvement (CDI), also known as "clinical documentation integrity", is the best practices, processes, technology, people, and joint effort between providers and billers that advocates the completeness, precision, and validity of provider documentation inherent to transaction code sets (e.g. ICD-10-CM, ICD-10-PCS, CPT, HCPCS) sanctioned by the Health Insurance ...
Unwarranted variations in medical practice refer to the differences in care that cannot be explained by the illness/medical need or by patient preferences. The term “unwarranted variations” was first coined by Dr. John Wennberg when he observed small area (geographic) and practice style variations, which were not based on clinical rationale. [5]
The health data produced are an integral part of health information management, and are used by local and national governments, private healthcare organizations and international agencies for various purposes, including medical and health services research, epidemiological studies, health resource allocation, case mix management, public health ...