14+ Common Medical Billing Abbreviations

Medical Billing Abbreviations

Medical coding is vital to quickly process patient claims so that a doctor can seamlessly carry on his practice. You’ll have to understand complex insurance terms, services, and procedures before long.

Understanding coded information might be a piece of cake for you, but even if it’s not that easy, you can grasp it with dedication and practice. Here’s the list of some common abbreviations, such as POS, PCP, CPT, and many others, you have to study to figure out how well you can do in this profession.  

Frequently Used Medical Acronyms

EDI: The Electronic Data Interchange, a computer system, distributes claims to the insurance companies you work with. As a result, the companies can be routed to the relevant person. Plus, you need to know the code CMS, which is the Centers for Medicaid (MCD) and Medicare (MCR) Services. Make sure you thoroughly learn those programs owing to the growing number of financially underprivileged and older patients. You’ll be coordinating with private insurance companies and federal government insurers because both services are handled by the U.S. Department of Health and Human Services.

AMA: This must be noted for insurance when a patient leaves the doctor’s care Against Medical Advice (AMA). 

PPO: A Preferred Provider Organization (PPO) helps the insured get more flexibility within his plan, than an HMO, to see more doctors. It complies with any doctor contracted within his insurance. PPO is the best choice for people who have been seeing the same doctors for years and those who often travel out of town. 

EOB: An Explanation of Benefits (EOB) enables the patient to find out what services were covered under his plan and the percentage paid.

HIPAA: The Health Insurance Portability and Accountability Act helps secure patients’ medical conditions and personal information from misuse. The authorities have enforced strict rules about patients’ rights to access their information and how those in healthcare can manage documents.

Do you know how to improve your medical claims billing process?

POS: A Point of Service is a kind of insurance that offers economical rates if the insured goes to in-network (INN) Health Maintenance Organization (HMO) providers. In an HMO practice, a set of the procedural plan is followed by a large body of professionals. First, the patient will see his Primary Care Physician (PCP), and then, if required, the PCP will refer the patient to a specialist for advanced treatment.

CPT: The Current Procedural Terminology code is usually five digits and added to every bill.

For standard intake information, other common medical abbreviations include DOB (Date of Birth), DOS (Date of Service), EDC (Effective Date of Coverage), SSN (Social Security Number), NP (New Patient), BC (Blue Cross), and BS (Blue Shield).

Final Word

Are you overwhelmed by seeing so many abbreviations? No worries, you’ll be well-versed in them after just a few repetitions or less. You may forget some complex codes of services that have nothing to do with you often. However, keep them in mind as much as possible for quicker processing speed and a smoother day.

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