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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. [1] This bill is called a claim. [2]
A 2019 report commissioned by Congress found that for traumatic brain injury (TBI) exams, a condition that often co-occurs with PTSD, "although VBA has systems in place to review the consistency of its process, it does not appear to measure reliability or validity," and they recommended that VA institute "a program of standard patients [f] to ...
In a personal injury lawsuit in common law jurisdictions, the two basic forms of compensatory damages that may be awarded are economic damages, compensation for the injured person's past and future financial costs and losses, and non-economic damages, compensation for the pain and suffering which results from an injury. As many jurisdictions ...
Workers' compensation insurance carriers, auto insurance carriers, and self-insured employers have a legal right to this request. Should the doctor/therapist performing the independent medical examination conclude that a patient's medical condition is not related to a compensable event, the insurer may deny the claim and refuse payment.
Maximum Medical Improvement (MMI) occurs when an injured person reaches a state where their condition cannot be improved further or their healing process reaches a Treatment Plateau . It can mean that the patient has fully recovered from the injury or their medical condition has stabilized to the point that no major medical or emotional change ...
However, out-of-network medical billing has become common for privately insured patients even when they receive care in an in-network hospital, creating a substantial financial burden. [13] Surprise balance billing is when an out-of-network provider bills an individual for services that were not covered by the insurance plan.
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A catastrophic injury is a severe injury to the spine, spinal cord, or brain. [1] It may also include skull or spinal fractures . [ 2 ] This is a subset of the definition for the legal term catastrophic injury , which is based on the definition used by the American Medical Association .