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  2. Health care finance in the United States - Wikipedia

    en.wikipedia.org/wiki/Health_care_finance_in_the...

    Most of the differences are explained by differences in the amount of "supply-sensitive" care available in an area. Acute hospital care accounts for over half (55%) of the spending for Medicare beneficiaries in the last two years of life, and differences in the volume of services provided is more significant than differences in price.

  3. Medical billing - Wikipedia

    en.wikipedia.org/wiki/Medical_billing

    Achieving a high clean claims rate is a key metric for measuring the efficiency of the billing cycle. Creation of the claim is where medical billing most directly overlaps with medical coding because billers take the ICD/CPT codes used by the medical coders and creates the claim. Step 6: Monitoring payor Adjudication [4]

  4. Chargemaster - Wikipedia

    en.wikipedia.org/wiki/Chargemaster

    The chargemaster may be alternatively referred to as the "charge master", "hospital chargemaster", or the "charge description master" (CDM). [4] [5] It is a comprehensive listing of items billable to a hospital patient or a patient's health insurance provider. [3] [6] It is described as "the central mechanism of the revenue cycle" of a hospital ...

  5. Why Americans pay so much more for health care in 2024 - AOL

    www.aol.com/why-americans-pay-much-more...

    But it’s hard to blame any one sector of health care for the runup in spending. In the 1970s, spending by hospitals grew at a faster rate than other sectors, according to a KFF analysis. Since ...

  6. Usual, customary and reasonable - Wikipedia

    en.wikipedia.org/wiki/Usual,_customary_and...

    Usual, customary, and reasonable (UCR) is an American method of generating health care prices, [1] described as "more or less whatever doctors decided to charge". [2] ...

  7. Fee-for-service - Wikipedia

    en.wikipedia.org/wiki/Fee-for-service

    When physicians cannot bill for a service, it serves as a disincentive to perform that service if other billable options exist. Electronic referral, when a specialist evaluates medical data (such as laboratory tests or photos) to diagnose a patient instead of seeing the patient in person, would often improve health care quality and lower costs ...

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