RISK OR NO RISK
Manual used to represent disease/disorder condition and their location or specificity of the human body in the format of codes.
What is ICD? or What is International Classification of Diseases?
An Individual, Entity or Organization who provides any form of medical treatment to a patient
Allows a member to visit whatever in-network physician or healthcare provider you wish without first requiring a referral from a primary care physician.
5 digit numeric codes assigned to every task and service a medical practitioner may provide to a patient including medical, surgical, and diagnostic services.
A promise of compensation for specific potential future losses in exchange for a periodic payment.
The member, cannot go outside the plan's network for care but does not need a referral an in-network specialist.
Examples are codes for Durable Medical Equipment, drugs administered, or Diagnostic Radiology Services.
What is HCPCS? or What is Healthcare Common Procedure Coding System?
It combines characteristics of the health maintenance organization (HMO) and the preferred provider organization (PPO)
Develops and revises diagnosis codes and publishes an updated manual on October 1st of every year.
What is WHO(World Health Organization)?
The purpose is to make health insurance more affordable for those with little or no coverage.
Develops and maintains CPT codes and updates once every year in January.
What is AMA (American Medical Association)?