TL;DR
Insurance Terminology: Premium, deductible, copay, coinsurance, EOB, prior authorization, formulary, appeals.
Insurance Terminology
Definition
Premium, deductible, copay, coinsurance, EOB, prior authorization, formulary, appeals.
Common Errors
Medical assistants must avoid these errors related to insurance terminology:
- Hemolysis: redraw, often caused by vigorous mixing or small-gauge needle
- Syncope: lower head, apply cool compress, do not leave unattended
- Nerve injury: remove needle immediately if patient reports shooting pain
- Failing to verify patient identity using two identifiers before any procedure
Safety Considerations
Safety considerations for insurance terminology in the medical office include proper technique and universal precautions.
Intramuscular injections: angle 90 degrees, sites include Vastus lateralis (thigh), Deltoid (upper arm), Ventrogluteal (preferred for adults), Dorsogluteal (avoided due to sciatic nerve risk). Maximum volume: Deltoid max 1mL, VG/VL max 3mL. Needle: 21-23G, 1-1.5 inch.
Step-by-Step Procedure
Procedure: Blood pressure measurement (relevant to insurance terminology).
Technique: Seated, arm at heart level, cuff on bare upper arm, inflate 30mmHg above palpated systolic, deflate 2-3mmHg/sec, Korotkoff sounds: first=systolic, disappear=diastolic
Normal values: Normal: under 120/under 80. Elevated: 120-129/under 80. Stage 1 HTN: 130-139 or 80-89. Stage 2: 140+ or 90+.
Practical Example
Clinical Procedure: Temperature measurement is relevant to insurance terminology.
Technique: Oral (under tongue, lips closed, 3-5 min), tympanic (pull ear up and back for adults), temporal (across forehead)
Normal values: Oral: 97.8-99.1 F. Rectal: +1 F. Axillary: -1 F. Tympanic: close to core.
Why It Matters
Insurance terminology tested on MA exam.
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