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In order to be clear on the payment of a medical billing claim, the health care provider or medical biller must have complete knowledge of different insurance plans that insurance companies are offering, and the laws and regulations that preside over them. Large insurance companies can have up to 15 different plans contracted with one provider.
The acronym HCPCS originally stood for HCFA Common Procedure Coding System, a medical billing process used by the Centers for Medicare and Medicaid Services (CMS). Prior to 2001, CMS was known as the Health Care Financing Administration (HCFA).
In August 1970, Senator Ted Kennedy (D-MA) introduced a bipartisan national health insurance bill—without any cost sharing—developed with the Committee for National Health Insurance founded by United Auto Workers (UAW) president Walter Reuther, with a corresponding bill introduced in the House the following month by Representative James ...
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 ...
An explanation of benefits (commonly referred to as an EOB form) is a statement sent by a health insurance company to covered individuals explaining what medical treatments and/or services were paid for on their behalf. [1] The EOB is commonly attached to a check or statement of electronic payment. An EOB typically describes:
(The Center Square) – New laws go into effect in Illinois Jan. 1 that will put new restrictions on the state’s health insurance industry. Gov. J.B. Pritzker said the Healthcare Protection Act ...
On December 24, 2009, the Senate passed an alternative health care bill, the Patient Protection and Affordable Care Act (H.R. 3590). [2] In 2010, the House abandoned its reform bill in favor of amending the Senate bill (via the reconciliation process) in the form of the Health Care and Education Reconciliation Act of 2010.
A health insurance policy is a insurance contract between an insurance provider (e.g. an insurance company or a government) and an individual or his/her sponsor (that is an employer or a community organization).
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