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2. Medical billing - Wikipedia

   en.wikipedia.org/wiki/Medical_billing

   Medical billing is a payment practice within the United States healthcare system. The process involves the systematic submission and processing of healthcare claims for reimbursement. Once the services are provided, the healthcare provider creates a detailed record of the patient's visit, including the diagnoses, procedures performed, and any ...

3. Diagnosis-related group - Wikipedia

   en.wikipedia.org/wiki/Diagnosis-related_group

   Large urban labor-related rate $2,809.18 Large urban non-labor-related $1,141.85 Wage index 1.4193 Standard Federal Rate: labor * wage index + non-labor rate $5,128.92 DRG relative weight (RW) factor 1.8128 Weighted payment: Standard Federal Rate * DRG RW $9,297.71 Disproportionate Share Payment (DSH) 0.1413 Indirect medical education (IME) 0.0744

4. Fee-for-service - Wikipedia

   en.wikipedia.org/wiki/Fee-for-service

   Fee-for-service. Fee-for-service (FFS) is a payment model where services are unbundled and paid for separately. [1] In health care, it gives an incentive for physicians to provide more treatments because payment is dependent on the quantity of care, rather than quality of care. However evidence of the effectiveness of FFS in improving health ...

5. Bundled payment - Wikipedia

   en.wikipedia.org/wiki/Bundled_payment

   Advocates of bundled payments note: 25 to 30 percent of hospital procedures are wasteful without improving the quality of care. [47] Unlike fee-for-service, bundled payment discourages unnecessary care, encourages coordination across providers, and potentially improves quality.

6. Chargemaster - Wikipedia

   en.wikipedia.org/wiki/Chargemaster

   The chargemaster may be alternatively referred to as the "charge master", "hospital chargemaster", or the "charge description master" (CDM). [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]

7. Balance billing - Wikipedia

   en.wikipedia.org/wiki/Balance_billing

   Balance billing, sometimes called surprise billing, is a medical bill from a healthcare provider billing a patient for the difference between the total cost of services being charged and the amount the insurance pays. [1]