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An American billing clerk preparing a detailed invoice. (1992) Visiting a doctor might feel like a straightforward one-on-one interaction, but it is actually part of a much larger and more complex system involving information exchange and payment processing.
Certified Medical Reimbursement Specialist (CMRS) is a voluntary national credential that was created specifically for the medical billing professional. The American Medical Billing Association (AMBA) has been providing this industry certification and designation for nearly a decade.
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 PMAG is composed of performance measurement experts representing the Agency for Healthcare Research and Quality (AHRQ), the American Medical Association (AMA), the Centers for Medicare and Medicaid Services (CMS), the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), the National Committee for Quality Assurance (NCQA ...
The AAPC was founded in 1988, [6] as the American Academy of Professional Coders, with the aim of providing education and certification to coders working in physician-based settings. These settings include group practices and specialty centers (i.e. non-hospital settings).
As the largest single purchaser of medical services in the U.S., Medicare's fixed pricing schedules have a significant impact on the market. These prices are set based on CMS' analysis of labor and resource input costs for different medical services based on recommendations by the American Medical Association. [35]
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