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

  3. Independent medical review - Wikipedia

    en.wikipedia.org/wiki/Independent_medical_review

    An independent medical review (IMR) is the process where physicians review medical cases in order to provide claims determinations for health insurance payers, workers compensation insurance payers or disability insurance payers. Peer review also is used in order to define the review of sentinel events in a hospital environment for quality ...

  4. 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).

  5. 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 ...

  6. 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.

  7. How direct pay works with pet insurance - AOL

    www.aol.com/finance/direct-pay-works-pet...

    This may include your pet’s medical history and insurance policy details. ... Processing claims: Insurers must approve and process claims submitted by the veterinarian, ...

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