Healthcare Payer & Providers Glossary

Looking for detailed information on healthcare RCM? This comprehensive guide has everything you need to know about revenue cycle management.

Learn how automation in RCM can improve efficiency and productivity for healthcare providers in this guide.

Learn everything about outsourcing RCM in this guide. Healthcare providers get answers to all their questions.

Enacted in 1935, the Social Security Act provides benefits for old-age retirees, dependent mothers and children, the jobless, victims of work-related accidents, blind people, and people who have physical disabilities.

In healthcare, a third-party payer refers to any public or private entity, such as an insurance company, government program, or managed care organization, that assumes financial responsibility for covering some or all of a patient’s medical costs.

A tier is a designated category within the revenue cycle that organizes patient accounts or billing items by criteria such as risk, dollar value, or claim complexity, ensuring focused management and tailored operational strategies.

Unbundling in healthcare refers to the process of separating and billing different healthcare service components that are bundled together.

The Veterans Health Administration (VHA) is the largest government agency that offers specialized care, primary care, and related social and medical support services to the U.S. veterans.

The waiting period in healthcare is the duration for which you have to wait before getting benefits, which begins from the date of policy commencement.