Summary
Health care in the United States is based on a reimbursement system; all medical staff are required to bill for various medical treatments and the health care provider is reimbursed by a payer—such as a private insurance company or government health care fund. The reimbursements are based on specific billing codes and the claims initiated and submitted by the health care provider. The environment, however, is rapidly changing and becoming extremely complex, such that billing codes and code edits change quarterly. Understanding the meaning of the billing codes and applying them properly for the services provided to patients is challenging. As a result, many clinics and/or hospital facilities end up either over charging or under charging insurance, or there is missing documentation requiring additional communication between hospital and payee, or missed charges. One study reported that radiation oncology billing error rates ranged annually from 11 percent to 37 percent, corresponding to $7M to $25M for a medium sized clinic.By assigning activities to billing codes the health-case worker inputs the activity and the software assigns the correct code to the activity using a rules-based system.
Feb. 1, 2012
B5, No.1600, North Guoquan Rd, Yangpu, Shanghai
info@yintrust.com
021-65679356
Premium