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  2. Chargemaster - Wikipedia

    en.wikipedia.org/wiki/Chargemaster

    The chargemaster may be alternatively referred to as the "charge master", "hospital chargemaster", or the "charge description master" (CDM). [4][5] It is a comprehensive listing of items billable to a hospital patient or a patient's health insurance provider. [3][6] It is described as "the central mechanism of the revenue cycle" of a hospital. [7]

  3. SGR Repeal and Medicare Provider Payment Modernization Act of ...

    en.wikipedia.org/wiki/SGR_Repeal_and_Medicare...

    The provisions in this bill that would pay for changes in the SGR formula by delaying some provisions of the Affordable Care Act were unpopular with Democrats, leading to the Protecting Access to Medicare Act of 2014 (H.R. 4302; 113th Congress), a bill that would simply delay the April 1, 2014 SGR Medicare cuts until March 2015.

  4. Clinical coder - Wikipedia

    en.wikipedia.org/wiki/Clinical_coder

    Clinical coder. A clinical coder —also known as clinical coding officer, diagnostic coder, medical coder, or nosologist —is a health information professional whose main duties are to analyse clinical statements and assign standardized codes using a classification system. The health data produced are an integral part of health information ...

  5. Resource-based relative value scale - Wikipedia

    en.wikipedia.org/wiki/Resource-based_relative...

    Using the 2005 Conversion Factor of $37.90, Medicare paid 1.57 * $37.90 for each 99213 performed, or $59.50. Most specialties charge 200–400% of Medicare rates for their procedures and collect between 50 and 80% of those charges, after contractual adjustments and write-offs. [citation needed]

  6. Fee-for-service - Wikipedia

    en.wikipedia.org/wiki/Fee-for-service

    Fee-for-service. Fee-for-service (FFS) is a payment model where services are unbundled and paid for separately. [1] In health care, it gives an incentive for physicians to provide more treatments because payment is dependent on the quantity of care, rather than quality of care. However evidence of the effectiveness of FFS in improving health ...

  7. Medical billing - Wikipedia

    en.wikipedia.org/wiki/Medical_billing

    Medical billing is a payment practice within the United States healthcare system. The process involves the systematic submission and processing of healthcare claims for reimbursement. Once the services are provided, the healthcare provider creates a detailed record of the patient's visit, including the diagnoses, procedures performed, and any ...

  8. Current Procedural Terminology - Wikipedia

    en.wikipedia.org/wiki/Current_Procedural_Terminology

    The Current Procedural Terminology (CPT) code set is a procedural code set developed by the American Medical Association (AMA). It is maintained by the CPT Editorial Panel. [1] The CPT code set describes medical, surgical, and diagnostic services and is designed to communicate uniform information about medical services and procedures among ...

  9. AAPC (healthcare) - Wikipedia

    en.wikipedia.org/wiki/AAPC_(healthcare)

    The AAPC, previously known by the full title of the American Academy of Professional Coders, [4] is a professional association for people working in specific areas of administration within healthcare businesses in the United States. [5] AAPC is one of a number of providers who offer services such as certification and training to medical coders ...