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    • U.S. Healthcare Market Overview
      • Healthcare System Overview
      • The Provider Overview
      • Accountable Care Timelines
    • The Payor Overview
      • Role of World Health Organization
      • International Classification of Diseases
  • Funding for
    Technology Creation
    • Angel Capital Data
    • Venture Capital and Corporate Venture Capital Data
  • Commercialization
    & Startups
    • Innovation as a Process of Connected Steps
    • Investment Must be Connected to Exit
    • Align with Industry Norms
  • Government &
    Regulation
    • Overview of Government Structures
    • How Policy Turns Into Law
  • Public &
    Population Health
    • History of Public Health
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Government & Regulation

The US Healthcare Reimbursement System Summary

How does the US Reimbursement System work?

  • The US healthcare reimbursement system works by paying healthcare professionals the fees incurred when their services are used. Payment is made either through the Public or Private Insurance programs.
  • Three essential criteria must be met for reimbursement to take place. These are coding, coverage, and payment.
    • Coding is the standardized terminology for medical terms so that definition and billing of services are uniformed
    • Coverage is what service, product, or technology are within the list of what would be covered by a payer’s health plan
    • Payment is the dollar amount for the service received. The payer decides what payment plan he/she will use for such service and then the claim is processed for reimbursement to proceed
  • The presentation below shows a summary of the US Healthcare Reimbursement System
  • Overview of Government Structures
  • How Policy Turns Into Law
  • Health Policy and Reform Legislation
    • Health Policy
  • The US Healthcare Reimbursement System Summary
  • Insurance, Reimbursement and the Data It Generates
  • Gross Domestic Product (GDP)
    • Global GDP World Map
    • Global GDP according to Region
    • United States (US) GDP per State
  • Why does healthcare cost so much?
  • Distribution of the National Health Expenditure
  • Population and Age Demographics
  • Employment in the United States
  • Income, Poverty, and Health Insurance
    • Income
    • Poverty
    • Health Insurance
  • Overview of Government Structures
  • How Policy Turns Into Law
  • Health Policy and Reform Legislation
    • Health Policy
  • The US Healthcare Reimbursement System Summary
  • Insurance, Reimbursement and the Data It Generates
  • Gross Domestic Product (GDP)
    • Global GDP World Map
    • Global GDP according to Region
    • United States (US) GDP per State
  • Why does healthcare cost so much?
  • Distribution of the National Health Expenditure
  • Population and Age Demographics
  • Employment in the United States
  • Income, Poverty, and Health Insurance
    • Income
    • Poverty
    • Health Insurance

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