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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.
The second is the healthcare provider, a term that encompasses not only physicians but also hospitals, physical therapists, emergency rooms, outpatient facilities, and other entities delivering medical services. The third and final party is the payor, typically an insurance company, which facilitates reimbursement for the services rendered.
Hospitals were forced to leave the "nearly risk-free world of cost reimbursement" [12] and face the uncertain financial consequences associated with the provision of health care. [13] DRGs were designed to provide practice pattern information that administrators could use to influence individual physician behaviour. [11]
Analyst Andrew Brackmann writes that the market reaction is justified, as reimbursement should enable the company to fully capitalize on its opportunities rather than limiting volumes to control ...
Every hospital system maintains its own chargemaster. [6] Traditionally, hospitals regarded their chargemaster, alongside the medical codes that catalogue the billing items, as a trade secret that is central to their business, and state laws and courts have historically accepted the view that these are proprietary information. [8] [9]
Health care analytics is the health care analysis activities that can be undertaken as a result of data collected from four areas within healthcare: (1) claims and cost data, (2) pharmaceutical and research and development (R&D) data, (3) clinical data (such as collected from electronic medical records (EHRs)), and (4) patient behaviors and preferences data (e.g. patient satisfaction or retail ...
Image source: The Motley Fool. Omega Healthcare Investors (NYSE: OHI) Q4 2024 Earnings Call Feb 06, 2025, 10:00 a.m. ET. Contents: Prepared Remarks. Questions and Answers. Call Participants
Image source: The Motley Fool. UnitedHealth Group (NYSE: UNH) Q4 2024 Earnings Call Jan 16, 2025, 8:45 a.m. ET. Contents: Prepared Remarks. Questions and Answers. Call Participants
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