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  2. Revenue cycle management - Wikipedia

    en.wikipedia.org/wiki/Revenue_cycle_management

    The claim is then sent out from the provider to the payer in an ANSI 837 5010 standard format. Denials can be sent back as a response to the claim from the payer stating a specific reason of why the claim cannot be adjudicated. This is where denial management processes help to ensure that there is an immediate resolution to these denials.

  3. 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. [1] This bill is called a claim. [2]

  4. Event-driven process chain - Wikipedia

    en.wikipedia.org/wiki/Event-driven_Process_Chain

    Example of a more complex EPC diagram (in German). An event-driven process chain (EPC) is a type of flow chart for business process modeling. EPC can be used to configure enterprise resource planning execution, and for business process improvement. It can be used to control an autonomous workflow instance in work sharing.

  5. Computerized physician order entry - Wikipedia

    en.wikipedia.org/wiki/Computerized_physician...

    Computerized physician order entry (CPOE), sometimes referred to as computerized provider order entry or computerized provider order management (CPOM), is a process of electronic entry of medical practitioner instructions for the treatment of patients (particularly hospitalized patients) under his or her care.

  6. UnitedHealth unit will start processing $14 billion medical ...

    www.aol.com/news/unitedhealths-change-start...

    Change Healthcare is a key player in the U.S. healthcare system that depends heavily on insurance, processing about 50% of medical claims for around 900,000 physicians, 33,000 pharmacies, 5,500 ...

  7. Process flow diagram - Wikipedia

    en.wikipedia.org/wiki/Process_flow_diagram

    A process flow diagram (PFD) is a diagram commonly used in chemical and process engineering to indicate the general flow of plant processes and equipment. The PFD displays the relationship between major equipment of a plant facility and does not show minor details such as piping details and designations.

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