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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 ...
Utilization management. Utilization management (UM) or utilization review is the use of managed care techniques such as prior authorization that allow payers, particularly health insurance companies, to manage the cost of health care benefits by assessing its appropriateness before it is provided using evidence-based criteria or guidelines.
The Joint Commission is one of the most widely used accreditation organizations. The International Society for the Quality in Healthcare (ISQua) is the umbrella organization responsible for accrediting the Joint Commission accreditation scheme in the US and Accreditation Canada International, as well as accreditation organizations in the United ...
National Council of State Boards of Nursing. College of Nursing accreditation. American Association of Colleges of Nursing. Commission on Collegiate Nursing Education. National League for Nursing. Advanced practice nursing college accreditation. American College of Nurse-Midwives. Council of Accreditation of Nurse Anesthesia Educational Programs.
Website. www .lifepointhealth .net. LifePoint Health is an American company that provides healthcare services in growing regions, rural communities and small towns. It was established in 1999 and is headquartered in Brentwood, Tennessee. As of November 16, 2018, it operated 89 hospital campuses in 30 states with more than $6 billion in revenues ...
Diagnosis-related group (DRG) is a system to classify hospital cases into one of originally 467 groups, [1] with the last group (coded as 470 through v24, 999 thereafter) being "Ungroupable". This system of classification was developed as a collaborative project by Robert B Fetter, PhD, of the Yale School of Management , and John D. Thompson ...
Medical outsourcing. Medical outsourcing is a business process used by organizations like hospitals, nursing homes, and healthcare provider practices to obtain physician, nursing, healthcare technician, or other services in a managed services model.
Evaluation and Management Coding. Evaluation and management coding (commonly known as E/M coding or E&M coding) is a medical coding process in support of medical billing. Practicing health care providers in the United States must use E/M coding to be reimbursed by Medicare, Medicaid programs, or private insurance for patient encounters.