HIPAA stands for the Health Insurance Portability and Accountability Act, which is a federal law enacted in 1996 in the United States. HIPAA consists of several provisions that aim to protect individuals’ rights and privacy related to their healthcare information. Here are the key components of HIPAA: Privacy Rule: The HIPAA Privacy Rule establishes standards […]
Category: General
What is a National Provider Identifier (NPI)?
The National Provider Identifier (NPI) is a unique identification number assigned to healthcare providers in the United States. It is a 10-digit numeric identifier that remains constant throughout a provider’s career, regardless of job changes or location. Here are some key points about the National Provider Identifier (NPI): Purpose: The NPI was established by the […]
What is an Encounter Form in Healthcare?
An encounter form, also known as a superbill or charge capture form, is a document used in healthcare to record the services provided during a patient’s visit or encounter with a healthcare provider. It serves as a summary of the visit and contains information necessary for medical billing and coding purposes. Here are the key […]
What does Revenue cycle management (RCM) meaning in Healthcare
Revenue cycle management (RCM) refers to the process of managing the financial aspects of a healthcare organization’s interactions with patients, insurance companies, and other third-party payers to optimize revenue generation and ensure timely reimbursement for services rendered. It encompasses the entire lifecycle of a patient account, from scheduling and registration to claims submission, payment processing, […]
What is EOB in medical billing?
An Explanation of Benefits (EOB) is a document provided by an insurance company to the policyholder and the healthcare provider, detailing the outcome of a medical claim. It serves as a summary of how the insurance company processed the claim, the amounts billed, the amounts covered, and any remaining balances or patient responsibilities. Here’s what […]
What is Superbill In medical billing?
In medical billing, a superbill is a document or form used by healthcare providers to capture essential information about the services rendered during a patient’s visit. It serves as a record of the procedures, diagnoses, and other relevant details necessary for submitting claims to insurance companies or for patient billing purposes. Here are some key […]
What is fee schedule in medical billing?
In medical billing, a fee schedule refers to a predetermined list of prices or payment rates established by an insurance company, government program, or healthcare organization for specific healthcare services. The fee schedule outlines the maximum allowable amount or the specific reimbursement rate that will be paid for each service or procedure provided to patients. […]