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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.
In the United States, direct primary care (DPC) is a type of primary care billing and payment arrangement made between patients and medical providers, without sending claims to insurance providers. It is an umbrella term , incorporating various health care delivery systems that involve direct financial relationships between patients and health ...
The CPT code set describes medical, surgical, and diagnostic services and is designed to communicate uniform information about medical services and procedures among physicians, coders, patients, accreditation organizations, and payers for administrative, financial, and analytical purposes.
HCPCS includes three levels of codes: Level I consists of the American Medical Association's Current Procedural Terminology (CPT) and is numeric.; Level II codes are alphanumeric and primarily include non-physician services such as ambulance services and prosthetic devices, and represent items and supplies and non-physician services, not covered by CPT-4 codes (Level I).
Evaluation and management coding (commonly known as E/M coding or E&M coding) is a medical coding process in support of medical billing.Practicing health care providers in the United States must use E/M coding to be reimbursed by Medicare, Medicaid programs, or private insurance for patient encounters.
The Major Diagnostic Categories (MDC) are formed by dividing all possible principal diagnoses (from ICD-9-CM) into 25 mutually exclusive diagnosis areas. MDC codes, like diagnosis-related group (DRG) codes, are primarily a claims and administrative data element unique to the United States medical care reimbursement system. DRG codes also are ...
IMO's clinical interface terminology, which helps to map diagnostic terminologies to medical concepts and billing codes, was launched in 1995. Products such as Problem (IT) and Procedure (IT) aim to help physicians more easily choose the correct medical term for their cases, which then aids in finding the correct billing code. [ 1 ]
OpenEMR is a medical practice management software which also supports Electronic Medical Records (EMR). It is ONC Complete Ambulatory EHR certified [2] [3] [4] and features fully integrated electronic medical records, practice management for a medical practice, scheduling, and electronic billing.