|
Resource-based Relative Value Scale
Resource-based relative value scale (RBRVS) is a schema used to determine how much money medical providers should be paid. It is partially used by Medicare in the United States and by nearly all health maintenance organizations (HMOs). RBRVS assigns procedures performed by a physician or other medical provider a '' relative value'' which is adjusted by geographic region (so a procedure performed in Manhattan is '' worth'' more than a procedure performed in Dallas). This value is then multiplied by a fixed ''conversion factor,'' which changes annually, to determine the amount of payment. RBRVS determines prices based on three separate factors: physician work (54%), practice expense (41%), and malpractice expense (5%).''Medicare physician fees geographic adjustment indices are valid in design, but data and methods need refinement.'' Washington, DC: Government Accountability Office, March 2005. (Publication no. GAO-05-119.) The procedure codes and their associated RVUs are made publ ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Model (abstract)
A conceptual model is a representation of a system. It consists of concepts used to help people know, understand, or simulate a subject the model represents. In contrast, physical models are physical object such as a toy model that may be assembled and made to work like the object it represents. The term may refer to models that are formed after a conceptualization or generalization process. Conceptual models are often abstractions of things in the real world, whether physical or social. Semantic studies are relevant to various stages of concept formation. Semantics is basically about concepts, the meaning that thinking beings give to various elements of their experience. Overview Models of concepts and models that are conceptual The term ''conceptual model'' is normal. It could mean "a model of concept" or it could mean "a model that is conceptual." A distinction can be made between ''what models are'' and ''what models are made of''. With the exception of iconic models, su ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Payment By Results
Payment by Results (PbR) is a type of public policy instrument whereby payments are contingent on the independent verification of results. It is being actively promoted by a number of governments for more effective implementation of domestic policy. There is also increasing interest in the field of international development, where PBR is often referred to either as 'results-based aid' (where the funding relationship is between a donor and a recipient country) or 'results-based financing' (where the funding relationship is between a developing country government or a development agency, and public or private sector providers). There are also a number of other terms in use which can often lead to confusion and a lack of clarity. ESMAP (2013"Results-Based Financing in the Energy Sector: An Analytical Guide" p.45. The World Bank, Washington, DC PbR instruments have three key features: * Payments for pre-agreed results * Recipient discretion over how the results are achieved * Independ ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Blue Cross And Blue Shield Association
Blue Cross Blue Shield Association (BCBS, BCBSA) is a federation, or supraorganization, of, in 2022, 34 independent and locally operated BCBSA companies that provide health insurance in the United States to more than 106 million people. It was formed in 1982 from the merger of its two namesake organizations: Blue Cross was founded in 1929 and became the Blue Cross Association in 1960, while Blue Shield emerged in 1939 and the Blue Shield Association was created in 1948. Commonly called "The Blues" within the healthcare insurance industry, the organization has two offices, one in Chicago and one in Washington, D.C. The main office is in Chicago in the Illinois Center at 225 North Michigan Avenue. The BCBSA claims to control access to the Blue Cross and Blue Shield trademarks and names across the United States and in more than 170 other countries, which it then licenses to the affiliated companies for specific, exclusive geographic service areas. It has affiliated plans in all 50 ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Procedure Codes
Procedure codes are a sub-type of medical classification used to identify specific surgical, medical, or diagnostic interventions. The structure of the codes will depend on the classification; for example some use a numerical system, others alphanumeric. Examples of procedure codes International * International Classification of Primary Care (ICPC-2), as well as procedure codes; ICPC-2 also contains diagnosis codes, reasons for encounter (RFE), and process of care. * International Classification of Procedures in Medicine (ICPM) and International Classification of Health Interventions (ICHI) * SNOMED CT North American * Canadian Classification of Health Interventions (CCI) (used in Canada. Replaced CCP.) * Current Dental Terminology (CDT) * Healthcare Common Procedure Coding System (including Current Procedural Terminology) (for outpatient use; used in United States) * ICD-10 Procedure Coding System (ICD-10-PCS) (for inpatient use; used in United States) * ICD-9-CM Volume 3 ( ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Medical Billing (United States)
Medical billing is a payment practice within the United States healthcare system. The process involves a healthcare provider obtaining insurance information from a patient and filing, following up on and appealing claims with health insurance companies in order to receive payment for services rendered, such as testing, treatments, and procedures. The same process is used for most insurance companies, whether they are private companies or government sponsored programs. Medical coding reports what the diagnosis and treatment were and prices are applied accordingly. Medical billers are encouraged, but not required by law, to become certified by taking an exam such as the CMRS Exam, RHIA Exam, CPB Exam and others. Certification schools are intended to provide a theoretical grounding for students entering the medical billing field. Some community colleges in the United States offer certificates, or even associate degrees, in the field. Those seeking advancement may be cross-trained i ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Omnibus Budget Reconciliation Act Of 1989
Omnibus may refer to: Film and television * ''Omnibus'' (film) * Omnibus (broadcast), a compilation of Radio or TV episodes * ''Omnibus'' (UK TV series), an arts-based documentary programme * ''Omnibus'' (U.S. TV series), an educational program * ''Omnibus'' (talk show), an Italian series Literature * Omnibus edition, a collection of literary works * Omnibus Press, a book publisher * Omnibus, a Marvel Comics character associated with the Leader Music Albums * ''Omnibus'' (album), a 2006 album by Tarkio * ''Omnibus'', a 2008 album by Blue Mountain * ''Omnibus'', a 2001 album by Ruby Braff * ''Omnibus: The 60s Singles As and Bs'', a 1999 album by The Move Songs * "Omnibus", a song by the Move on the B-side of " Wild Tiger Woman" * "Omnibus", a song by XTC from '' Nonsuch'' Transport * Horse-drawn omnibus or horsebus, a large, enclosed and sprung horse-drawn vehicle used for passenger transport * Motor omnibus or autobus, a road vehicle designed to carry passengers Ot ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
George H
George may refer to: People * George (given name) * George (surname) * George (singer), American-Canadian singer George Nozuka, known by the mononym George * George Washington, First President of the United States * George W. Bush, 43rd President of the United States * George H. W. Bush, 41st President of the United States * George V, King of Great Britain, Ireland, the British Dominions and Emperor of India from 1910-1936 * George VI, King of Great Britain, Ireland, the British Dominions and Emperor of India from 1936-1952 * Prince George of Wales * George Papagheorghe also known as Jorge / GEØRGE * George, stage name of Giorgio Moroder * George Harrison, an English musician and singer-songwriter Places South Africa * George, Western Cape ** George Airport United States * George, Iowa * George, Missouri * George, Washington * George County, Mississippi * George Air Force Base, a former U.S. Air Force base located in California Characters * George (Peppa Pig), a 2-year-old ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
William Hsiao
William C. Hsiao (; born January 17, 1936), an American economist, is the K.T. Li Research Professor of Economics at the Harvard T.H. Chan School of Public Health in Boston, Massachusetts. He is internationally recognized for his work on health care financing and social insurance. Hsiao is a graduate of Ohio Wesleyan University and received his PhD in economics from Harvard University. He is a member of the National Academy of Medicine, the Society of Actuaries, and the National Academy of Social Insurance. He has received teaching awards from Harvard graduate students on several occasions. He resides in Cambridge, Massachusetts, with his wife, Ruth, a former lecturer at Tufts University. He has two sons and four grandchildren. Biography Hsiao was born in Beijing, China, and as a teenager immigrated to the United States, where his father was an economic advisor for the Kuomintang delegation to the United Nations. He grew up in Forest Hills, Queens, and attended New York public ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Harvard University
Harvard University is a private Ivy League research university in Cambridge, Massachusetts. Founded in 1636 as Harvard College and named for its first benefactor, the Puritan clergyman John Harvard, it is the oldest institution of higher learning in the United States and one of the most prestigious and highly ranked universities in the world. The university is composed of ten academic faculties plus Harvard Radcliffe Institute. The Faculty of Arts and Sciences offers study in a wide range of undergraduate and graduate academic disciplines, and other faculties offer only graduate degrees, including professional degrees. Harvard has three main campuses: the Cambridge campus centered on Harvard Yard; an adjoining campus immediately across Charles River in the Allston neighborhood of Boston; and the medical campus in Boston's Longwood Medical Area. Harvard's endowment is valued at $50.9 billion, making it the wealthiest academic institution in the world. Endowment inco ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
American Medical Association
The American Medical Association (AMA) is a professional association and lobbying group of physicians and medical students. Founded in 1847, it is headquartered in Chicago, Illinois. Membership was approximately 240,000 in 2016. The AMA's stated mission is "to promote the art and science of medicine and the betterment of public health." The Association also publishes the ''Journal of the American Medical Association'' (JAMA). The AMA also publishes a list of Physician Specialty Codes which are the standard method in the U.S. for identifying physician and practice specialties. The American Medical Association is governed by a House of Delegates as well as a board of trustees in addition to executive management. The organization maintains the AMA Code of Medical Ethics, and the AMA Physician Masterfile containing data on United States Physicians. The ''Current Procedural Terminology'' coding system was first published in 1966 and is maintained by the Association. It has also publi ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Federal Register
The ''Federal Register'' (FR or sometimes Fed. Reg.) is the official journal of the federal government of the United States that contains government agency rules, proposed rules, and public notices. It is published every weekday, except on federal holidays. The final rules promulgated by a federal agency and published in the ''Federal Register'' are ultimately reorganized by topic or subject matter and codified in the '' Code of Federal Regulations'' (CFR), which is updated annually. The ''Federal Register'' is compiled by the Office of the Federal Register (within the National Archives and Records Administration) and is printed by the Government Publishing Office. There are no copyright restrictions on the ''Federal Register''; as a work of the U.S. government, it is in the public domain. Contents The ''Federal Register'' provides a means for the government to announce to the public changes to government requirements, policies, and guidance. * Proposed new rules and regulat ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Centers For Medicare And Medicaid Services
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. In addition to these programs, CMS has other responsibilities, including the administrative simplification standards from the Health Insurance Portability and Accountability Act of 1996 (HIPAA), quality standards in long-term care facilities (more commonly referred to as nursing homes) through its survey and certification process, clinical laboratory quality standards under the Clinical Laboratory Improvement Amendments, and oversight of HealthCare.gov. CMS was previously known as the Health Care Financing Administration (HCFA) until 2001. CMS actively inspects and reports on every nursing home in the United States. This includes maintaini ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
