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Medical Coding is converting a diagnosis or symptoms, procedures, and drugs into codes and Medical billing is billing insurance companies and patients for procedures and office visits. Their work is submitted to insurance companies for payment purposes, data collection, research, billing and quality improvement purposes.
Centers for Medicare & Medicaid Services (CMS)
The Centers for Medicare & Medicaid Services (CMS) is the agency within the U.S. Department of Health and Human Services (HHS) that administers the nation's major healthcare program. The Centers for Medicare & Medicaid Services (CMS) is part of the U.S. Department of Health and Human Services. CMS oversees many federal healthcare programs, including those that involve health information technology such as the meaningful use incentive program for electronic health records (EHR).
PURPOSE:
The CMS seeks to strengthen and modernize the Nation's health care system, to provide access to high quality care and improved health at lower costs.
The Centers for Medicare and Medicaid Service's (CMS) Hierarchical Condition Category (HCC) risk adjustment model is used to calculate risk scores, which will adjust capitated payments made for aged and disabled beneficiaries enrolled in Medicare Advantage (MA) and other plans
History of CMS:
After Medicare and Medicaid were established in 1965, the Social Security Administration -- through the then Department of Health, Education and Welfare -- administered federal health programs. In 1977, the former Health Care Financing Administration (HCFA) took over administration of Medicare and Medicaid. In 2001, HCFA became CMS.
CMS uses quality measures to support a patient-centered health care system anchored by quality, accessibility, affordability, innovation, and accountability. The National Impact Assessment of the Centers for Medicare & Medicaid Services (CMS) Quality Measures Reports (Impact Assessment Reports) examine data-driven results that support progress toward CMS objectives to improve public health, implement measures meaningful to patients and providers, minimize provider burden, focus on outcomes whenever possible, identify significant opportunities for improvement, and support a transition to population-based payment models. These reports are required by section 1890A(a)(6) of the Social Security Act
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