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  2. Healthcare Common Procedure Coding System - Wikipedia

    en.wikipedia.org/wiki/Healthcare_Common...

    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).

  3. Medical billing - Wikipedia

    en.wikipedia.org/wiki/Medical_billing

    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] The payor returns the claim back to the medical biller and the biller evaluates how much of the bill the patient owes, after insurance is taken out.

  4. Ambulatory Payment Classification - Wikipedia

    en.wikipedia.org/wiki/Ambulatory_Payment...

    APCs or Ambulatory Payment Classifications are the United States government's method of paying for facility outpatient services for the Medicare (United States) program. A part of the Federal Balanced Budget Act of 1997 made the Centers for Medicare and Medicaid Services create a new Medicare "Outpatient Prospective Payment System" (OPPS) for hospital outpatient services -analogous to the ...

  5. National Correct Coding Initiative - Wikipedia

    en.wikipedia.org/wiki/National_Correct_Coding...

    The National Correct Coding Initiative (NCCI) is a Centers for Medicare & Medicaid Services (CMS) program designed to prevent improper payment of procedures that should not be submitted together. There are two categories of edits:

  6. Medicare Coverage for Hospital Bills After Death - AOL

    www.aol.com/medicare-coverage-hospital-bills...

    Medicare coverage ends on the date an enrolled person dies. Doctors have one year after that date to submit claims, so a person may continue to receive bills for deductibles, copayments, and ...

  7. What are the Medicare respite care guidelines? - AOL

    www.aol.com/medicare-respite-care-guidelines...

    There are currently no guidelines on how many times per billing period Medicare will pay for respite care. Summary Original Medicare Part A and Medicare Advantage may pay for 95% of the costs of ...

  8. Prospective payment system - Wikipedia

    en.wikipedia.org/wiki/Prospective_payment_system

    The PPS was established by the Centers for Medicare and Medicaid Services (CMS), as a result of the Social Security Amendments Act of 1983, specifically to address expensive hospital care. Regardless of services provided, payment was of an established fee. The idea was to encourage hospitals to lower their prices for expensive hospital care.

  9. What is HETS in Medicare? - AOL

    www.aol.com/lifestyle/hets-medicare-013800100.html

    The Hospital-Acquired Condition (HAC) Reduction Program within Medicare encourages hospitals to prioritize hospitalized people’s safety and implement best practices to reduce the likelihood of ...

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