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.

Common Healthcare Acronyms and Their Meanings

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.

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!

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.

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.

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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