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Chargemasters include thousands of hospital services, medical procedures, equipment fees, drugs, supplies, and diagnostic evaluations such as imaging and blood tests. [ 6] Each item in the chargemaster is assigned a unique identifier code and a set price that are used to generate patient bills. [ 6] Every hospital system maintains its own ...
Diagnosis-related group. 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 ...
Jimmy Carter signs Medicare-Medicaid Anti-Fraud and Abuse Amendments into law. The Office of Inspector General for the U.S. Department of Health and Human Services, as mandated by Public Law 95-452 (as amended), is established to protect the integrity of Department of Health and Human Services (HHS) programs, to include Medicare and Medicaid programs, as well as the health and welfare of the ...
The Centers for Medicare & Medicaid Services ( CMS) is a federal agency within the United States Department of Health and Human Services (HHS) that administers the Medicare program and works in partnership with state governments to administer Medicaid, the Children's Health Insurance Program (CHIP), and health insurance portability standards.
Reviews and reputation. Blue Cross Blue Shield is a widely known health insurance company. It has provided health coverage since 1929 and offered Medicare coverage since the program began in the ...
A Federally Qualified Health Center ( FQHC) is a reimbursement designation from the Bureau of Primary Health Care and the Centers for Medicare and Medicaid Services of the United States Department of Health and Human Services. This designation is significant for several health programs funded under the Health Center Consolidation Act (Section ...
Medicare Advantage ( Medicare Part C, MA) is a type of health plan offered by Medicare-approved private companies that must follow rules set by Medicare. Most Medicare Advantage Plans include drug coverage (Part D). Under Part C, Medicare pays a sponsor a fixed payment. The sponsor then pays for the health care expenses of enrollees.
The Anthem medical data breach was a medical data breach of information held by Elevance Health, known at that time as Anthem Inc. On February 4, 2015, Anthem, Inc. disclosed that criminal hackers had broken into its servers and had potentially stolen over 37.5 million records that contain personally identifiable information from its servers. [ 1 ]