• Case-rate methodology

      Discover how case-rate methodology works, its benefits, and examples. Learn how this fixed-payment model simplifies billing and promotes cost efficiency in healthcare.

    • Charge description

      Discover how charge descriptions enhance billing accuracy and transparency. Learn their importance in claims processing and see examples in emergency care and dental cleaning.

    • Charge description master (CDM)

      The Charge Description Master (CDM) is a vital resource in healthcare, containing a comprehensive list of services and supplies along with their corresponding charges.

    • Charge status indicator

      A charge status indicator is a code used in healthcare to uniquely identify a charge's status (pending, denied, or billed).

    • Clinical validation denial

      Understand clinical validation denial, its impact on claims, and how to avoid it. Explore examples and strategies for ensuring accurate and compliant documentation.

    • Community rating

      Community rating is referred to as a healthcare pricing model in which insurance premiums are calculated based on the average cost of healthcare services.

    • Cost report

      Explore cost reports in healthcare, their impact on reimbursements, and types like Medicare, skilled nursing, and clinic cost reports. Learn how they guide financial transparency.

    • Cost-of-living adjustment (COLA)

      Explore how cost-of-living adjustments (COLA) impact healthcare salaries, Social Security, and Medicare. Learn about its purpose, examples, and regulatory guidelines.

    • Covered condition

      A covered condition in healthcare refers to the medical conditions that are eligible for reimbursement by the healthcare payers.

    • Covered service

      A covered service can be defined as a medical procedure, treatment, or healthcare service that qualifies for reimbursement under a patient's insurance plan or government program.