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A Health Reimbursement Arrangement, also known as a Health Reimbursement Account (HRA), [1] is a type of US employer-funded health benefit plan that reimburses employees for out-of-pocket medical expenses and, in limited cases, to pay for health insurance plan premiums.
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A medical biller then takes the coded information, combined with the patient's insurance details, and forms a claim that is submitted to the payors. [2] Payors evaluate claims by verifying the patient's insurance details, medical necessity of the recommended medical management plan, and adherence to insurance policy guidelines. [4]
Reimbursement is the act of compensating someone for an out-of-pocket expense by giving them an amount of money equal to what was spent. [1]Companies, governments and nonprofit organizations may compensate their employees or officers for necessary and reasonable expenses; under US [2] [3] law, these expenses may be deducted from taxes by the organization and treated as untaxed income for the ...
The system is also referred to as "the DRGs", and its intent was to identify the "products" that a hospital provides. One example of a "product" is an appendectomy. The system was developed in anticipation of convincing Congress to use it for reimbursement, to replace "cost based" reimbursement that had been used up to that point.
Fee-for-service (FFS) is a payment model where services are unbundled and paid for separately. [1]In health care, it gives an incentive for physicians to provide more treatments because payment is dependent on the quantity of care, rather than quality of care.
The current year's HCPCS, CPT-4, and ICD-10 Code Books are needed to take the exam, or you can use a free trial of the AMBA's coding software. The AMBA offers a CMRS Study Guide . Purchasing the guide is optional but recommended because 80% of the exam is taken from the study guide.
Decompression sickness (DCS; also called divers' disease, the bends, aerobullosis, and caisson disease) is a medical condition caused by dissolved gases emerging from solution as bubbles inside the body tissues during decompression.
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