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  2. Revenue cycle management - Wikipedia

    en.wikipedia.org/wiki/Revenue_cycle_management

    The revenue cycle can be defined as, "all administrative and clinical functions that contribute to the capture, management, and collection of patient service revenue." [ 1 ] It is a cycle that describes and explains the life cycle of a patient (and subsequent revenue and payments) through a typical healthcare encounter from admission ...

  3. 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).

  4. Utilization management - Wikipedia

    en.wikipedia.org/wiki/Utilization_management

    Utilization management is "a set of techniques used by or on behalf of purchasers of health care benefits to manage health care costs by influencing patient care decision-making through case-by-case assessments of the appropriateness of care prior to its provision," as defined by the Institute of Medicine [1] Committee on Utilization Management by Third Parties (1989; IOM is now the National ...

  5. 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]

  6. Evidence-based nursing - Wikipedia

    en.wikipedia.org/wiki/Evidence-based_nursing

    One method of research for evidence-based practice in nursing is 'qualitative research': The word implies an entity and meanings that are not experimentally examined or measured in terms of quantity, amount, frequency, or intensity. With qualitative research, researchers learn about patient experiences through discussions and interviews.

  7. Health information management - Wikipedia

    en.wikipedia.org/wiki/Health_information_management

    In addition, they may apply the science of informatics to the collection, storage, analysis, use, and transmission of information to meet legal, professional, ethical and administrative records-keeping requirements of health care delivery. [1] They work with clinical, epidemiological, demographic, financial, reference, and coded healthcare data.

  8. Clinical audit - Wikipedia

    en.wikipedia.org/wiki/Clinical_audit

    The multidisciplinary team discusses individual anonymous cases to reflect upon the way the team functioned and to learn for the future. In the primary care setting, this is described as a 'significant event audit'. Surgical audit – Data collection of all surgical cases, followed by ongoing review and assessment of performance and outcomes ...

  9. Bundled payment - Wikipedia

    en.wikipedia.org/wiki/Bundled_payment

    The negative aspects of the project included difficulties in billing and collection. [16] A 2001 paper examining three of the original four hospitals with comparable "micro-cost" data determined that "the cost reductions primarily came from nursing intensive care unit, routine nursing, pharmacy, and catheter lab." [17]