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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.
Authorization hold (also card authorization, preauthorization, or preauth) is a service offered by credit and debit card providers whereby the provider puts a hold of the amount approved by the cardholder, reducing the balance of available funds until the merchant clears the transaction (also called settlement), after the transaction is completed or aborted, or because the hold expires.
The Fair Credit Billing Act (FCBA) is a United States federal law passed during the 93rd United States Congress and enacted on October 28, 1974 as an amendment to the Truth in Lending Act (codified at 15 U.S.C. § 1601 et seq.) and as the third title of the same bill signed into law by President Gerald Ford that also enacted the Equal Credit ...
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 ...
The California Department of Health Care Services (DHCS) is a department within the California Health and Human Services Agency that finances and administers a number of individual health care service delivery programs, including Medi-Cal, which provides health care services to low-income people.
The U.S. Justice Department has filed an antitrust lawsuit against Visa, alleging that the financial services behemoth uses its size and dominance to stifle competition in the debit card market ...
Prior authorization is a check run by some insurance companies or third-party payers in the United States before they will agree to cover certain prescribed medications or medical procedures. [2] There are a number of reasons that insurance providers require prior authorization, including age, medical necessity, the availability of a generic ...
The Department of Financial Protection and Innovation has a long history, dating back to the formation of California's first banking department. It became the DFPI in 2020 with the passage of the California Consumer Financial Protection Law (CCFPL). [2] Formation of State Banking Department (1909) and State Corporations Department (1913)
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