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A data structure file is available separately from CMS. [6] As of June 2024, the file download size is 947.84 MB, and the raw database file (npidata_pfile_20050523-20240512.csv) is 9.3 GB when extracted. [7] The size of the data has been steadily growing over time. The size of the raw database file was 8.8GB in June 2023, and 8.2GB in June 2022.
Achieving a high clean claims rate is a key metric for measuring the efficiency of the billing cycle. Creation of the claim is where medical billing most directly overlaps with medical coding because billers take the ICD/CPT codes used by the medical coders and creates the claim. Step 6: Monitoring payor Adjudication [4]
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.
Accredited Claims Adjuster: ACA Accredited Claims Professional: ACP Accredited Claims Professional Candidate: ACAc Associate in Claims: AIC Applied Microbial Remediation Technician: AMRC Casualty General Adjuster: CGA Certified Claims Adjuster: CCA Certified Claims Professional: CCP Certified Claims Professional Candidate: CCPc Chartered ...
HIPAA replaced various identifiers used by health plans, Medicare, Medicaid, and other government programs with an NPI. [62] The NPI is unique and national, never re-used, and except for institutions, a provider usually can have only one. However, the NPI does not replace a provider's DEA number, state license number, or tax identification number.
The Western Regional Examining Board (WREB) is one of five examination agencies for dentists and dental hygienists in the United States.The other examination agencies are, Council of Interstate Testing Agencies, Central Regional Dental Testing Service, Northeast Regional Board of Dental Examiners, Southern Regional Testing Agency.
An 834 file contains a string of data elements, with each representing a fact, such as a subscriber’s name, hire date, etc. The entire string is called a transaction set. The 834 is used to transfer enrollment information from the sponsor of the insurance coverage, benefits, or policy to a payer.
The Delta Dental Plans Association, also known as simply Delta Dental, is an American network of dental insurance companies composed of 39 independent Delta Dental members operating in all 50 states, the District of Columbia and Puerto Rico. These member companies provide coverage to 85 million people, enrolled in over 157,000 groups.
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