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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 ]
A separate committee, the Specialty Society Relative Value Scale Update Committee (RUC), [7] meets three times a year to set new values, [8] determines the Relative Value Units (RVUs) for each new code, and revalues all existing codes at least once every five years. The RUC has 29 members, 23 of whom are appointed by major national medical ...
Some form of on-the-job training is also usually provided in the first months on the job until the coder can earn an intermediate or advanced level of certification and accumulate time on the job. For further academic training, a baccalaureate or master's degree in medical information technology, or a related field, can be earned by those who ...
CPT coding is similar to ICD-10-CM coding, except that it identifies the services rendered, rather than the diagnosis on the claim. Whilst the ICD-10-PCS codes also contains procedure codes, those are only used in the inpatient setting. [5]
The pay scale was originally created with the purpose of keeping federal salaries in line with equivalent private sector jobs. Although never the intent, the GS pay scale does a good job of ensuring equal pay for equal work by reducing pay gaps between men, women, and minorities, in accordance with another, separate law, the Equal Pay Act of 1963.
A pay scale (also known as a salary structure) is a system that determines how much an employee is to be paid as a wage or salary, based on one or more factors such as the employee's level, rank or status within the employer's organization, the length of time that the employee has been employed, and the difficulty of the specific work performed.