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  2. Certified medical reimbursement specialist - Wikipedia

    en.wikipedia.org/wiki/Certified_Medical...

    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.

  3. Centers for Medicare & Medicaid Services - Wikipedia

    en.wikipedia.org/wiki/Centers_for_Medicare...

    The Centers for Medicare & Medicaid Services (CMS) is a federal agency within the United States Department of Health and Human Services (HHS) that administers the Medicare program and works in partnership with state governments to administer Medicaid, the Children's Health Insurance Program (CHIP), and health insurance portability standards.

  4. Medical billing - Wikipedia

    en.wikipedia.org/wiki/Medical_billing

    In order to be clear on the payment of a medical billing claim, the health care provider or medical biller must have complete knowledge of different insurance plans that insurance companies are offering, and the laws and regulations that preside over them. Large insurance companies can have up to 15 different plans contracted with one provider.

  5. Medicare Advantage - Wikipedia

    en.wikipedia.org/wiki/Medicare_Advantage

    The CMS Innovation Center's Medicare Advantage Value-Based Insurance Design (VBID) model tests customized benefits that are designed to better manage disease and address social needs, including food insecurity and social isolation. The VBID Hospice Benefit Component provides access to palliative/hospice services.

  6. Minimum Data Set - Wikipedia

    en.wikipedia.org/wiki/Minimum_Data_Set

    MDS information is transmitted electronically by nursing homes to the MDS database in their respective states. MDS information from the state databases is captured into the national MDS database at Centers for Medicare and Medicaid Services (CMS). Sections of MDS (Minimum Data Set): Identification Information; Hearing, Speech and Vision

  7. National Provider Identifier - Wikipedia

    en.wikipedia.org/wiki/National_Provider_Identifier

    NPI data is downloadable from CMS. The downloadable database was updated monthly until December 2012, and has been issued weekly since. 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]

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