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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.
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]
In the US a certificate of medical necessity is a document required by Centers for Medicare and Medicaid Services to substantiate in detail the medical necessity of an item of durable medical equipment or a service to a Medicare beneficiary. [1]
As the AMA decided in April 1960, the Current Medical Terminology (CMT) handbook was first published in June 1962 – 1963 to standardize terminology of the Standard Nomenclature of Diseases and Operations (SNDO) and International Classification of Diseases (ICD), and for the analysis of patient records, and was aided by an IBM computer. [22]
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.
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