Language Guide

1. Prior Authorization: When you need an appointment with a doctor or a type of testing such as a stress test, or an ultrasound and you call to schedule these, this term may be brought up. I noticed an increase of people are asked to call the ordering provider's office and request a prior authorization before they can be scheduled. This is particularly important; it has to do with your insurance and your coverage. A prior authorization when needed is to simply ensure that your insurance will cover your visit and must be obtained before you are scheduled. This ensures that your visit or test will not be cancelled, delaying your care, and will make sure you will not get billed for the entire visit.

2. Ambulatory Referral: When you get a referral from a provider you may see this term on your referral. You get a referral after being evaluated by a medical provider, or treated for a medical treatment or procedure. This simply means that you are mobile or able to walk after the treatment. This is for the referred providers knowledge of the state you are in. Referrals provide your diagnosis, insurance coverage, and referring provider name, etc. to improve your experience when you visit them. They will be able to discuss why you are there and answer your questions accurately based off of your specific reason of the visit. This also allows them to request any records needed from the referring provider or vice versa to give you the best health plan.

3. POA: A power of attorney document; You may be asked if you have a POA document on file if you are asking medical questions about someone other than you, if you are not their legal guardian. Or for example, if you are a grandparent taking your grandchild to urgent care or doctor visits, this document is to protect the patient and their medical history. POA forms are different for children and adults, but they must be signed by both consenting parties, notarized, and given to the clinic.

4. PCP: This stands for primary care physician, you may often be told to refer to your PCP, or contact your primary care physician.

5. Non-invasive: No tools will enter your body or break the skin. Some examples of a non-invasive procedure are, Xray's, Holter Monitoring, MRI, CT scans, and Echocardiograms. This term can be found in the order/referral to inform you of the type of procedure you will complete.

6. CPT Code: Current Procedural Terminology; These codes are used to identify medical procedures and services. For example, you call a DME company for your oxygen, they ask if you know the CPT code for your order. They are ensuring not only if it was ordered correctly but for the insurance as well. At times this code can be found on your referral, other times you will have to call the ordering provider and retrieve the code.

7. DME: Durable Medical Equipment; Examples of some DME are, wheelchairs, walkers, blood test strips for diabetics, and portable oxygen concentrators. DME is ordered from a medical provider after you have been evaluated.

8. Dox Telemed: This is a type of visit that is new to many of us due to COVID-19. Doximity Tele-Health is used for video visits, sort of like Zoom, but is used because it is easier for most patients to use since it does not require you to download an app. It allows the provider to see you, and you see the provider, to still have that office visit experience.