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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]
Revenue cycle management (RCM) is the process used by healthcare systems in the United States and all over the world to track the revenue from patients, from their initial appointment or encounter with the healthcare system to their final payment of balance. It is a normal part of health administration. The revenue cycle can be defined as, "all ...
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 ...
Prior to its acquisition by GE Healthcare, IDX had four primary lines of business: . Flowcast was the original application produced by IDX. It is a revenue cycle management system for medium to large physician groups, hospitals, and integrated delivery networks, and includes scheduling, billing and collections modules.
HCPCS was established in 1978 to provide a standardized coding system for describing the specific items and services provided in the delivery of health care. 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.
Computerized physician order entry (CPOE), sometimes referred to as computerized provider order entry or computerized provider order management (CPOM), is a process of electronic entry of medical practitioner instructions for the treatment of patients (particularly hospitalized patients) under his or her care.
The third College Football Playoff rankings will be released Tuesday with some major questions looming for the committee to answer.
Activity diagrams [1] are graphical representations of workflows of stepwise activities and actions [2] with support for choice, iteration, and concurrency. In the Unified Modeling Language, activity diagrams are intended to model both computational and organizational processes (i.e., workflows), as well as the data flows intersecting with the related activities.
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