Health
What is Medical Records?
1. Patient Name 2. Patient DOB 3. Referring Doctor 4. Rendering Doctor 5. Service Location Information 6. Exam time 7. CPT code with description 8. Indication: It indicates the sign and symptoms … Read more
DRG – Diagnosis Related Group
DRG: DRG system payment depends on the following factors: DRG-Related Weight: Hospital Payment Calculation:
Managed Care Organization (MCO) Plans
Managed care organization (MCO) is a type of health insurance that have contracts with healthcare providers to help members to provide services at low cost. Providers are contracted with health insurance under MCO plans and based on these plans, the cost of the patient’s health services is dependent. An individual can select any plan and … Read more
Current Procedural Terminology (CPT)
CPT codes are classified into 3 categories: I) Category I – This is the main category of CPT that used by providers to represent their different services and reimburse the payment. Below are the 6 different sections of this category with specialties and CPT range, 1. Anesthesia Services: 00100 – 01999 & 99100 – 991502. Surgery: 10004 – 699903. Radiology … Read more
What is Copay (PR-3) in Health Insurance?
A copay is a fixed amount that a patient is required to pay for a specific medical service or prescription, at the time the service is provided. It is denoted as copay (PR-3) This amount is typically predetermined by the patient’s health insurance plan and does not change based on the total cost of the … Read more
What are deductibles in health insurance?
Introduction: A deductible is the amount of money a patient has to pay out-of-pocket for covered healthcare services before their health insurance policy starts covering the costs it is also denoted as PR-1. It is a standard feature of most health insurance plans, and it resets annually. Once the deductible is met, the insurer will … Read more