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  2. 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 ...

  3. Ambulatory Payment Classification - Wikipedia

    en.wikipedia.org/wiki/Ambulatory_Payment...

    APCs or Ambulatory Payment Classifications are the United States government's method of paying for facility outpatient services for the Medicare (United States) program. A part of the Federal Balanced Budget Act of 1997 made the Centers for Medicare and Medicaid Services create a new Medicare "Outpatient Prospective Payment System " (OPPS) for ...

  4. Federally Qualified Health Center - Wikipedia

    en.wikipedia.org/wiki/Federally_Qualified_Health...

    An FQHC is a community-based organization that provides comprehensive primary care and preventive care, including health, oral, and mental health / substance abuse services to persons of all ages, regardless of their ability to pay or health insurance status. Thus, they are a critical component of the health care safety net. [ 1]

  5. List of open-source health software - Wikipedia

    en.wikipedia.org/wiki/List_of_open-source_health...

    Endrov Image and data viewer and editor. It is available under the BSD license. [40] GIMIAS is a workflow-oriented environment focused on biomedical image computing and simulation. It is available under a BSD-style license. [41] Ginkgo CADx Cross-platform open source DICOM viewer and dicomizer.

  6. Accreditation Association for Ambulatory Health Care

    en.wikipedia.org/wiki/Accreditation_Association...

    The Accreditation Association for Ambulatory Health Care (AAAHC), founded in 1979, is an American organization which accredits ambulatory health care organizations, including ambulatory surgery centers, office-based surgery centers, endoscopy centers, and college student health centers, as well as health plans, such as health maintenance organizations and preferred provider organizations.

  7. Utilization management - Wikipedia

    en.wikipedia.org/wiki/Utilization_management

    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.

  8. Chargemaster - Wikipedia

    en.wikipedia.org/wiki/Chargemaster

    Chargemaster. In the United States, the chargemaster, also known as charge master, or charge description master ( CDM ), is a comprehensive listing of items billable to a hospital patient or a patient's health insurance provider. In practice, it usually contains highly inflated prices at several times that of actual costs to the hospital.

  9. Ambulatory care - Wikipedia

    en.wikipedia.org/wiki/Ambulatory_care

    Ambulatory care sensitive conditions (ACSC) are illnesses or health conditions where appropriate ambulatory care prevents or reduces the need for hospital admission. Appropriate care for an ACSC can include one or more planned revisits to settings of ambulatory care for follow-up, such as when a patient is continuously monitored or otherwise ...

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