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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. The emergency medical treatment and active labor act (emtala) [1] is an act of the united states congress, passed in 1986 as part of the consolidated omnibus budget reconciliation act (cobra). The chargemaster may be alternatively referred to as the charge master, hospital chargemaster, or the charge description master (cdm)
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[4][5] it is a comprehensive listing of items billable to a hospital patient or a patient's health insurance provider Tricare is the civilian care component of the military health system, although historically it also included health care delivered in military medical treatment facilities. [3][6] it is described as the central mechanism of the revenue cycle of a hospital
[7] chargemasters include thousands of hospital.
A medical guideline (also called a clinical guideline, standard treatment guideline, or clinical practice guideline) is a document with the aim of guiding decisions and criteria regarding diagnosis, management, and treatment in specific areas of healthcare. The x12 834 edi enrollment implementation format is a standard file format in the united states for electronically exchanging health plan enrollment data between employers and health insurance carriers. In 2024, the company ranked 92 on the fortune 500 list, [2] which made it the highest ranked (by revenues) company based in kentucky [citation needed] it is the fourth largest health insurance provider in the u.s
Proper revenue cycle management is intended to ensure that billing errors are reduced so that reimbursements from the insurance companies are maximized
