Medical terminology is a standardized language used throughout the health care arena. For medical receptionists to fulfill their tasks and communicate with doctors, insurance providers, patients and like personnel, they’re required to know a range of medical terms.

Considerations

Medical terminology has a set linguistic structure. Each term consists of two or more elements (word root, prefix, suffix and combining vowel) that can be separated and identified by their parts. Medical terminology is used to depict procedures, protocols, pharmacology, anatomy, conditions and diseases.

Anatomy

It’s important to know the medical terms pertaining to the body’s parts, structures and systems (musculoskeletal, integumentary, cardiovascular, respiratory, immune, lymphatic, reproductive, digestive, excretory, nervous and urinary).

Health Insurance

Aside from the Health Insurance Portability and Accountability Act (HIPAA), it’s important to be aware of the various insurance plans patients have and the specific plans that the doctor accepts. Insurance plans generally fall into two large categories: indemnity plans and managed care plans.

Billing & Payments

Fundamental terminology in billing and payments includes benefits, claims, co-payment or out-of-pocket expense, deductible, pre-authorization, premium, network, revenue code, national provider identification and reimbursement.

Coding Systems

Coding systems are used to detail the medical services or procedures provided to a patient. Insurance companies also use the codes for reimbursement purposes. Current Procedural Terminology (CPT), International Classification of Diseases (ICD) and the Healthcare Common Procedure Coding System (HCPSC) are the systems used.