US Healthcare System.
This program aims to give a high-level overview of the US healthcare system. It describes the key entities in US healthcare and how they interact with each other. It introduces and describes key entities: Patient, Providers, Payers, and Clearinghouse. It also explains the key terms that are used in revenue cycle management to give you the complete picture of what happens after the patient gets service from a healthcare provider and how healthcare providers get paid.
This program will make you understand about medical codes, clearing houses, medical claims, different payment models and common data formats that are used in the US healthcare system.
Healthcare modules

Introduction to US healthcare
The US healthcare industry is one of the largest industries in the world and is a bit complex compared to other countries. It is a mixed system where publicly and privately financed market coverage coexists with each other.
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Introduction to Providers
‘Providers’ are individuals or institutes who provide healthcare treatment to patients. Providers are usually doctors, but they can also be nurses, surgeons, x-ray technicians, physical therapists, etc.
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Healthcare Payment Model
Healthcare payment models are billing systems by which healthcare organizations get paid for the services they provide to patients, whether by insurance payers or patients themselves.
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Medical Codes
Medical coding is the translation of medical reports into a short code used within the healthcare industry. This helps summarize otherwise cumbersome medical reports into efficient, data-friendly codes.
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Clearing House
A clearinghouse is the liaison between healthcare providers and insurance payers for managing end-to-end healthcare payment processes. A healthcare provider can submit a medical claim directly to the insurance payers or via a clearinghouse
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Medical Claims
Medical Claims are basically bills (i.e charges for medical care) that a healthcare provider submits to a patient’s insurance company (payer) for the reimbursement after the patient receives medical care.
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Common Data Formats
The most common data formats when it comes to healthcare data and its exchange are Electronic Data Interchange, Health Level 7 and Fast Health Interoperability Resources (FHIR)
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