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What is CMS in medical billing?

In the US, an agency was established to govern the various medical care programs that were in existence by the president Lyndon B. Johnson in 1965. This agency was called CMS-centres for Medicare and Medicaid Services. CMS oversees the administration of the medical care programs. It is a US federal agency that helps provide health insurance through Medicare, Medicaid etc.

CMS strives to provide better health care, wellness programs and accessibility. The programs that are supported by CMS are

  • Medicare – Medicare has widened its reach to include low-income groups, the aged, pregnant women, people with disabilities and ESRD. The Medicare program includes a) Hospital Insurance. b) Medical Insurance and c) Prescription drug coverage.
  • Medicaid – A program that was established to assist with medical costs.
  • Children’s health insurance program (CHIP) – This provides health care insurance to children in the low-income group. The aim is to improve children’s health all over the US.
  • Private Insurance-CMS also takes care of regulations in private insurance markets.
  • Prevention of insurance frauds – CMS analysis data that is gathered to prevent insurance frauds. It sets Medicare premiums and ensures smooth functioning and transparency in the health insurance sector.

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