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  2. Medical billing - Wikipedia

    en.wikipedia.org/wiki/Medical_billing

    Unlike denied claims, rejected claims must be corrected and resubmitted. Failure to address rejected claims can lead to significant revenue loss, making timely rework essential. Step 7: Creating Patient Statements [4] After the payor processes the claim and pays their portion, any remaining balance is billed to the patient in a separate statement.

  3. M21-1 Adjudication Procedures Manual - Wikipedia

    en.wikipedia.org/wiki/M21-1_Adjudication...

    The M21-1 Adjudication Procedures Manual does not constitute law, in contrast to statutes, federal regulations, and federal case law.The Department of Veterans Affairs has stated, “[t]he M21-1 is an internal manual used to convey guidance to VA adjudicators.

  4. SOAP note - Wikipedia

    en.wikipedia.org/wiki/SOAP_note

    The four components of a SOAP note are Subjective, Objective, Assessment, and Plan. [1] [2] [8] The length and focus of each component of a SOAP note vary depending on the specialty; for instance, a surgical SOAP note is likely to be much briefer than a medical SOAP note, and will focus on issues that relate to post-surgical status.

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  6. Health Insurance Portability and Accountability Act - Wikipedia

    en.wikipedia.org/wiki/Health_Insurance...

    Health Insurance Portability and Accountability Act of 1996; Other short titles: Kassebaum–Kennedy Act, Kennedy–Kassebaum Act: Long title: An Act To amend the Internal Revenue Code of 1986 to improve portability and continuity of health insurance coverage in the group and individual markets, to combat waste, fraud, and abuse in health insurance and health care delivery, to promote the use ...

  7. Managing general agent - Wikipedia

    en.wikipedia.org/wiki/Managing_general_agent

    In insurance, a managing general agent is defined legally as "an individual or business entity appointed by an underwriting insurer to solicit applications from agents for insurance contracts or to negotiate insurance contracts on behalf of an insurer and, if authorized to do so by an insurer, to effectuate and countersign insurance contracts".

  8. Clinical decision support system - Wikipedia

    en.wikipedia.org/wiki/Clinical_decision_support...

    Another sector of success for CDSS is in billing and claims filing. Since many hospitals rely on Medicare reimbursements to stay in operation, systems have been created to help examine both a proposed treatment plan and the current rules of Medicare to suggest a plan that attempts to address both the care of the patient and the financial needs ...

  9. Physical examination - Wikipedia

    en.wikipedia.org/wiki/Physical_examination

    The routine physical, also known as general medical examination, periodic health evaluation, annual physical, comprehensive medical exam, general health check, preventive health examination, medical check-up, or simply medical, is a physical examination performed on an asymptomatic patient for medical screening purposes.