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Revenue cycle management (rcm) is the process used by healthcare systems in the united states and other countries to track the revenue from patients, from their initial appointment or encounter with the healthcare system to final payment of a balance. Apcs or ambulatory payment classifications are the united states government's method of paying for facility outpatient services for the medicare (united states) program Medical billing, a payment process in the united states healthcare system, is the process of reviewing a patient's medical records and using information about their diagnoses and procedures to determine which services are billable and to whom they are billed.
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The chargemaster may be alternatively referred to as the charge master, hospital chargemaster, or the charge description master (cdm) Such software frequently allows users to capture patient demographics, schedule appointments, maintain lists of insurance payors, perform billing tasks, and generate reports [4][5] it is a comprehensive listing of items billable to a hospital patient or a patient's health insurance provider
[3][6] it is described as the central mechanism of the revenue cycle of a hospital
[7] chargemasters include thousands of hospital. It is a revenue cycle management system for medium to large physician groups, hospitals, and integrated delivery networks, and includes scheduling, billing and collections modules. A prospective payment system (pps) is a term used to refer to several payment methodologies for which means of determining insurance reimbursement is based on a predetermined payment regardless of the intensity of the actual service provided It includes a system for paying hospitals based on predetermined prices, from medicare
Payments are typically based on codes provided on the insurance.
