Front Office Vocabulary

Allowed Charge

The amount that is the most the payer wiil pay any provider to each procedure or service

Benefits

Payments for medical services

The way a diagnosis is communicated to the thrid-party payer on the healthcare claim

Established Patient

A patient who has seen the physician within the past 3 years. Determination is important using E/M codes

Fee Schedule

A list of the costs of common services and procedures performed by a physician

Guarantor

The patient, care-giver, or entity responsible for payment of the healthcare bill

Invoice

A listing of products or services redeemed that is used when billing for that product or service

Modified block letter

A letter format similar to full-block style except that the dateline; complimentary closing, signature block, and notations are aligned and begin at the center of the page or slightly to the right of the center

Modifier

1 or more 2-digit codes assigned to 5-digit main code to show that some special circumstance applied to the service or procedure that the physician performed

New Patient

Patient that, for CPT reporting purposes, has not received professional services from the physician within the past 3 years.

No Show

A patient who does not call to cancel and does not come to an appointment

Preauthorization

Authorization or approval for payment from a third-party payer requested in advance of a specific procedure.

Precertification

A determination of the amount of money that will be paid by a third-party payer for a specific procedure before the procedure is conducted

Primary care physician (PCP)

A physician who provides routine, medical care and referrals to specialists

Prioritizing

Sorting and dealing with matters in order of urgency and importance

Review of Systems

A process of gathering information about a patient’s health history regardless of apparent relevance to the Chief Complaint

Statement

Similar to invoice: a summary of total amounts owed including outstanding charges as well as payment received for serviced provided by the office

Telephone Triage

A process of determining the level of urgency of each incoming telephone call and how it should be handled

Third-party Payer

A health plan that agrees to carry the risk of paying for patient services

V/S

Vital Signs

Cx

Culture or Cervix

Sx

Symptoms

Hx

History

Dx

Diagnosis

NS

Normal Saline

BP

Blood Pressure

Rx

Prescription/Medical treatment

CXR

Chest X-ray

RS

Respiratory System

Discharge

When a patient is released from medical care or leaves a healthcare facility

Discharge Summary

Document that summarizes a patient’s treatment, condition, and instructions when leaving a healthcare facility

Full Block Letter

A business letter format where all parts are aligned to the left margin with no paragraph identations