Healthcare Acronyms You Need to Know

There’s nothing more frustrating than decoding healthcare acronyms while simultaneously navigating the in’s and out’s of starting a practice. We understand. But unfortunately, many times, those pesky acronyms stand for foundational concepts. Concepts representing the very building blocks of a successful practice. Therefore, having only a fuzzy idea of what CMS, EOB and all of the other three- or four-letter words mean just won't fly.

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Common Healthcare Acronyms and Their Meanings

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To get started, let's dip our toes in a few of the most commonly used healthcare acronyms. Below, we break down acronyms, what they stand for, and why they're important to know.

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Then, stay tuned for the next posts in the series as we dig deeper in some of the more complex healthcare acronyms and terms. Check out our next article, "What is a CPT Code?" to learn more about CPT codes and how to use them in your practice!

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General Acronyms

• DOS = Date of Service. You'll need this to file a claim with insurance and in records in case of an audit.
• DOB = Date of Birth. Same as above.
• POS = Place of Service. Same as above.

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Healthcare Organizations

• CMS = Center for Medicare and Medicaid Services. The governing body for services delivered to medicare and medicaid patients.
• AMA = American Medical Association. A powerful political body that lobbies congress for healthcare change. Created, trademarked, and maintain the CPT code set.
• HIPAA = Health Insurance Portability and Accountability Act. Set of guidelines establishing security and privacy rules, amongst other things.
• NUCC = National Uniform Claim Committee. Establishes and maintains the standards for completing claims forms.
• ANSI = American National Standards Institute. Establishes and maintains standards for electronic claims and other electronic communications about patient care.

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Insurance Acronyms

• CPT = Common Procedural Terminology. Codes used by providers to describe services rendered to clients/patients. (Click here to read our article about this topic!)
• EOB = Explanation of Benefits. Paper form mailed by insurance companies to patients and therapists explaining payments.
• ERA = Electronic Remittance Advice. Electronic version of the EOB, explaining payments to patients and therapists. Usually delivered through an EMR like TherapyAppointment.
• EFT = Electronic Funds Transfer. Direct deposit of insurance reimbursement. This is a separate process from registering for ERA's and must be completed to receive direct deposits.
• EDI = Electronic Data Interchange. This is the initial acknowledgement of receipt and initial processing of claims from insurance companies.
• HSA/FSA = Health Spending Account/Flexible Spending Account. Accounts clients may set up in addition to insurance that can be used to pay for qualifying medical expenses. To learn more, click here.
• ICD-10 = International Statistical Classification of Diseases - 10th revision. International standards for diagnostic codes.
• NPI = National Provider Identifier. 10 digit code that indicating that an individual or group is entitled to receive insurance reimbursement.
• PTAN = Provider Transaction Access Number. A provider's medicare identification number.

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