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  2. Relative value unit - Wikipedia

    en.wikipedia.org/wiki/Relative_value_unit

    The Omnibus Budget Reconciliation Act of 1989 enacted a Medicare fee schedule, and as of 2010 about 7,000 distinct physician services were listed. [2] The services are classified under a nomenclature based on the Current Procedural Terminology (CPT) to which the American Medical Association holds intellectual property rights. [ 2 ]

  3. Resource-based relative value scale - Wikipedia

    en.wikipedia.org/wiki/Resource-based_relative...

    Resource-based relative value scale. Resource-based relative value scale ( RBRVS) is a schema used to determine how much money medical providers should be paid. It is partially used by Medicare in the United States and by nearly all health maintenance organizations (HMOs). RBRVS assigns procedures performed by a physician or other medical ...

  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. Capitation (healthcare) - Wikipedia

    en.wikipedia.org/wiki/Capitation_(healthcare)

    Capitation (healthcare) Capitation is a payment arrangement for health care service providers. It pays a set amount for each enrolled person assigned to them, per period of time, whether or not that person seeks care. The amount of remuneration is based on the average expected health care utilization of that patient, with payment for patients ...

  6. Health care prices in the United States - Wikipedia

    en.wikipedia.org/wiki/Health_care_prices_in_the...

    Insurance companies, as payors, negotiate health care pricing with providers on behalf of the insured. Hospitals, doctors, and other medical providers have traditionally disclosed their fee schedules only to insurance companies and other institutional payors, and not to individual patients.

  7. 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 ...

  8. Usual, customary and reasonable - Wikipedia

    en.wikipedia.org/wiki/Usual,_customary_and...

    Usual, customary and reasonable. Usual, customary, and reasonable ( UCR) is an American method of generating health care prices, [ 1] described as "more or less whatever doctors decided to charge". [ 2] According to Steven Schroeder, Wilbur Cohen inserted UCR into the Social Security Act of 1965 "in an unsuccessful attempt to placate the ...

  9. Title insurance - Wikipedia

    en.wikipedia.org/wiki/Title_insurance

    Title insurance. Title insurance is a form of indemnity insurance, predominantly found in the United States and Canada, that insures against financial loss from defects in title to real property and from the invalidity or unenforceability of mortgage loans. Unlike some land registration systems in countries outside the United States, US states ...