Comprehensive Medical Assisting and Healthcare Insurance Key Concepts

Subjective

Information reported by the patient that cannot be observed or measured directly.

Objective

Information that can be observed or measured by a healthcare provider.

Acute

A condition that comes on suddenly and is typically severe in nature.

Chronic

A condition that persists over a long period of time, often lasting for months or years.

Characteristics of symptoms

Details about symptoms including location, radiation, quality, and severity.

Associated symptoms

Symptoms that occur alongside the primary complaint.

Aggravating factors

Conditions or activities that worsen a patient's symptoms.

Alleviating factors

Conditions or activities that improve a patient's symptoms.

Triage

The process of determining the priority of patients' treatments based on the severity of their condition.

Emergent

A situation requiring immediate medical attention.

HIPAA privacy requirements

Regulations that protect patient privacy and the confidentiality of health information.

Mensuration

The process of measuring a patient's body dimensions.

BMI

Body Mass Index; a measure of body fat based on height and weight.

VS

Vital Signs; measurements of the body's basic functions, including temperature, pulse, respiration, and blood pressure.

Palpation

The technique of using hands to examine the body for abnormalities.

Subnormal temperature/hypothermia

A body temperature that is lower than the normal range.

Auscultate

The act of listening to the internal sounds of the body, typically using a stethoscope.

Dyspnea

Difficult or labored breathing.

Eupnea

Normal, unlabored breathing.

Tachycardia

An abnormally rapid heart rate.

Bradycardia

An abnormally slow heart rate.

Arrhythmia

An irregular heartbeat.

Inspiration

The act of inhaling air into the lungs.

Expiration

The act of exhaling air from the lungs.

Pulse pressure

The difference between systolic and diastolic blood pressure.

Tachypnea

Abnormally rapid breathing.

Febrile

Having or showing symptoms of fever.

Afebrile

Without fever; normal body temperature.

Antagonist

A substance that interferes with or inhibits the physiological action of another.

Prescription

A written order from a healthcare provider for the preparation and administration of a medication.

Vial

A small container used to hold liquid medications or samples.

Pharmacology

The study of drugs and their effects on the body.

Scurvy

A disease caused by a deficiency of vitamin C, leading to symptoms like bleeding gums and fatigue.

Sleep apnea

A sleep disorder characterized by pauses in breathing or shallow breathing during sleep.

Amenorrhea

The absence of menstruation.

Binge

An episode of excessive eating or drinking.

Calorie

A unit of energy used to measure the energy content of foods.

Carbohydrate

A type of macronutrient found in many foods and a primary source of energy for the body.

Dietitian

A health professional who specializes in nutrition and diet planning.

Emaciation

The state of being abnormally thin or weak due to a lack of nutrition.

Insomnia

A sleep disorder characterized by difficulty falling or staying asleep.

Vitamins

Organic compounds that are essential for normal growth and nutrition, typically required in small quantities in the diet.

Minerals

Inorganic substances that are essential for various bodily functions.

Medicare Parts A, B, C and D

Medicare Part A covers hospital insurance, Part B covers medical insurance, Part C includes Medicare Advantage plans, and Part D covers prescription drug coverage.

Precertification

The process of obtaining approval from a health insurance company before a specific procedure or service is performed.

TRICARE

A health care program for military personnel, retirees, and their dependents.

CHAMPVA

A health care program for veterans and their families.

Co-payment

A fixed amount paid by a patient for a specific medical service, usually at the time of service.

Co-insurance

A type of health insurance where the insured pays a percentage of the costs of covered services after the deductible has been met.

Deductible

The amount a patient must pay out-of-pocket before insurance coverage begins.

Premium

The amount paid for an insurance policy, typically on a monthly basis.

Capitation

A payment arrangement where a healthcare provider is paid a set amount for each enrolled patient regardless of the number of services provided.

Carrier

An insurance company that provides health coverage.

Gatekeeper

A healthcare provider who coordinates patient care and determines if referrals to specialists are necessary.

Group insurance

A health insurance plan that covers a group of people, typically provided by an employer.

HMO

Health Maintenance Organization; a type of health insurance plan that requires members to use a network of doctors and hospitals.

Managed care

A system of health care delivery that aims to manage costs and quality of care.

Medicaid

A government program that provides health coverage for low-income individuals and families.

Pre-existing condition

A health issue that existed before an individual's health insurance policy went into effect.