Secondary Records/Databases
This legal document confirms a person's death and provides details on the date, time, location, and cause of death.
Death Certificate
Reporting of hospital visits for related diagnostic, imaging, or outpatient procedures.
Ambulatory Payment Classifications
A patient sees a doctor or visits a hospital.
Fee for service
Insurance Verification by registration clerk to verify name, demographics, and insurance
Front End Process
Hospitals and clinics can use registries to analyze patient outcomes and find ways to improve the quality of care for a specific patient group.
Quality Improvement
This is one of the most comprehensive and widely used nomenclatures in the world. It provides a vast collection of clinical terms for diagnoses, symptoms, procedures, and more.
SNOMED CT
The information documented in a patient's chart is used to determine the correct medical codes for diagnoses and procedures.
Review of documentation to ensure medical record supports assignment of diagnosis codes.
Middle Process
Researchers use data from registries to study rare diseases or to track the long-term effects of a medication or a medical device.
Clinical Research
Patient has a length of stay of 10 days, with reported principal diagnoses, procedures during an inpatient stay.
Diagnosis Related Group (DRG)
This is the prospective payment system used by Medicare to pay for physician services. The payment is based on the resources required to provide the service, including physician work, practice expenses, and malpractice insurance.
Resource-Based Relative Value Scale (RBRVS)
Middle Process
Registries such as a cancer or immunization registry, collect data to track the incidence of diseases and evaluate the success of vaccination programs.
Public Health
This nomenclature provides codes for medical, surgical, and diagnostic procedures and is used for billing and claims processing.
Current Procedural Terminology (CPT)
Formal requests for payment that a healthcare provider submits to a payer (like an insurance company, Medicare, or Medicaid) after providing a medical service to a patient.
Reimbursement Claim Process
Claim denials reviewed to submit an appeal with cover letter and scorecard supporting code assignment.
Back end process
This is the most common vital record. It's the official document that proves a person's legal name, date of birth, place of birth, and parentage.
Birth Certificate
While technically a classification system, it’s a critical part of the nomenclature landscape. It provides codes for diagnoses and is used for billing and mortality reporting
Funded by both the federal government and individual states. The federal government provides a matching fund to states for their expenditures.
Medicaid
A strategies to support the timely submission of claims as well as analyzing denials.
Denial Management