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  2. Medical billing - Wikipedia

    en.wikipedia.org/wiki/Medical_billing

    Medical billing, a payment process in the United States healthcare system, is the process of reviewing a patient's medical records and using information about their diagnoses and procedures to determine which services are billable and to whom they are billed.

  3. Physician Quality Reporting System - Wikipedia

    en.wikipedia.org/wiki/Physician_Quality...

    The requirements for eligibility become more complex over time. For example, in 2013 providers had to submit data on one out of the total possible measures to comply ...

  4. ANSI 834 Enrollment Implementation Format - Wikipedia

    en.wikipedia.org/wiki/ANSI_834_Enrollment...

    The X12 834 EDI Enrollment Implementation Format is a standard file format in the United States for electronically exchanging health plan enrollment data between employers and health insurance carriers.

  5. Case management (US healthcare system) - Wikipedia

    en.wikipedia.org/wiki/Case_management_(US...

    Case managers working for health care providers typically do the following: Verify coverage & benefits with the health insurers to ensure the provider is appropriately paid; Coordinate the services associated with discharge or return home; Provide patient education; Provide post-care follow-up; and; Coordinate services with other health care ...

  6. National Provider Identifier - Wikipedia

    en.wikipedia.org/wiki/National_Provider_Identifier

    A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). The NPI has replaced the Unique Physician Identification Number (UPIN) as the required identifier for Medicare services, and is used by other payers ...

  7. Centers for Medicare & Medicaid Services - Wikipedia

    en.wikipedia.org/wiki/Centers_for_Medicare...

    HCFA was renamed the Centers for Medicare and Medicaid Services on July 1, 2001. [9] [11] In 2013, a report by the inspector general found that CMS had paid $23 million in benefits to deceased beneficiaries in 2011. [12] In April 2014, CMS released raw claims data from 2012 that gave a look into what types of doctors billed Medicare the most. [13]

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  9. Medicare (United States) - Wikipedia

    en.wikipedia.org/wiki/Medicare_(United_States)

    Lyndon B. Johnson signing the Medicare amendment (July 30, 1965). Former president Harry S. Truman (seated) and his wife, Bess, are on the far right.. Originally, the name "Medicare" in the United States referred to a program providing medical care for families of people serving in the military as part of the Dependents' Medical Care Act, which was passed in 1956. [7]