People in the medical industry use terminologies that often sound foreign and intimidating to the uninitiated. To do a good job in the healthcare field as an admin professional, learning the language is key to understanding what is discussed, billed, or read, reducing mistakes that can be detrimental to patient safety and the quality of care patients receive.
Likewise, standardized language ensures compliance with industry regulations, such as HIPAA and other federal and state laws.
NCU is sharing some healthcare business terms our School of Health Sciences believes are essential for every healthcare administration professional to know.
9 Commonly Used Business Terminologies Healthcare Professionals Should Know
Accountable Care Organizations
Groups of hospitals, doctors, and other healthcare providers who work together to ensure coordinated, high-quality patient care are called ACOs or accountable care organizations.
Related Article: What is Interprofessional Education (IPE)?
Centers for Medicare & Medicaid Services
The CMS is an agency within the U.S. Department of Health and Human Services and is responsible for providing patients with health coverage through the various healthcare programs, including Medicare, Medicaid, and CHIP (Children’s Health Insurance Program).
This is the amount a patient pays for healthcare services before their insurance provider starts paying.
Durable medical equipment
DME for short, durable medical equipment are supplies or equipment required by healthcare providers for certain diseases, injuries, or disabilities. They include wheelchairs, walkers, crutches, ventilators, kidney machines, oxygen, nebulizers, monitors, traction equipment, and hospital beds.
Family practitioners are board-certified physicians whose scope of practice include children and adults.
Fee for service
Fee for service is a health insurance payment system that pays healthcare practitioners for every service they provide, no matter the outcome.
A gap analysis is a management technique used to identify healthcare issues and the discrepancies between what’s actually going on versus what needs to be going on.
Also called extra billing, balance billing happens when a healthcare provider bills a patient the difference between the healthcare charges and the amount the patient’s insurance company is willing to reimburse. For example, if the charges total $100 and the insurance can only cover $80, the remaining $20 is billed to the patient.
The Patient Protection and Affordable Care Act, also known as the Affordable Care Act (or informally, Obamacare) is a law enacted with the goal of providing access to affordable healthcare insurance.
For more health sciences terms that administrative professionals must learn this year, here’s a handy glossary from the American Speech-Language-Hearing Association (ASHA). A much longer list is also available at the Wisconsin Department of Public Instruction's website.