Medical Billing Glossary

Reading medical bills can be a daunting task, especially if you are unfamiliar with the terms used. All of the abbreviated letters signify some type of services that was performed, but unless you know medical terminology, you may be billed for services you never received. To this end, here are some important medical billing glossary terms you should be aware of the next time you receive a bill from a doctor, hospital, or insurance company.

Every bill comes with an account number, therefore, if you are wondering what the multiple numbers affixed to your statement refer to, it is simply your own account.

COB stands for Coordination of Benefits. If you have more than one insurance company, this determines who is responsible for payment.

Co-Payment is the amount you pay for a doctor visit or for prescription drugs. The type of insurance you have determines the amount of the co-payment.

CPT is simply a medical code used to describe what type of services was performed by your physician.

Deductible is the amount paid for medical services before the insurance company starts to pay.

Diagnosis Code is utilized to ascertain what type of illness you are being treated for.

EOB stands for Explanation of Benefits. This is the most important part of your billing statement and provides information on what services were performed, the amount of the payment which is approved by your insurance company, how much you paid, and any balance accrued.

Medicare Part A and B are often misinterpreted. Part A is for hospital care, while Part B is for services performed by your physician.

NCC or non-covered charges are those charges which are not covered by your insurane company.

NPP or non-participating provider also means that your doctor is not part of your insurance coverage.

PP is the participating provider, that is, the doctor or hospital used is accepted by your insurance company.

Referral allows you to seek the services of other doctors as long as you have permission in writing from your primary physician.

If you receive a medical bill and are uncertain as to what the codes and letters mean, contact your insurance provider so they can interpret the codes for you. There have been cases where errors occur and you may be billed for someone else’s services. The more knowledge you have about medical billing glossary terms, the better prepared you will be to read and understand your medical bills.