Reimbursement

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Reimbursement for services is what keeps providers in business. Hospitals and clinics draw from a number of different payers for reimbursement, including Medicare, Medicaid and private insurance companies. Reimbursement can be affected by the claims process, out-of-network payments, denials, audits and legislation. The fee-for-service model of healthcare has been hotly debated in the pages of Healthcare Finance News, as Congress, insurers and healthcare providers work together on establishing reimbursement rates and fee schedules that work for the entire industry.