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Healthcare shouldn’t be this complicated. Learn the terms that matter to make informed decisions about your health.

ADA (Americans with Disabilities Act)

A federal civil rights law that prohibits discrimination against individuals with disabilities in various areas, including employment, public accommodations, and government services. In healthcare, the ADA requires hospitals, clinics, and providers to offer accessible facilities, effective communication aids (like sign language interpreters), and reasonable accommodations to ensure patients with disabilities receive equitable care.

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Patient Rights

Activities of Daily Living (ADLs)

Basic self-care tasks such as bathing, dressing, eating, and mobility. ADLs are used to assess an individual’s level of independence and the need for assistance or care services.

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Healthcare Services

Advance Directive

A legal document outlining a patient’s preferences for medical care if they become unable to make decisions. It typically includes a living will and healthcare proxy.

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Patient Rights

Affordable Care Act (ACA)

A healthcare reform law designed to expand insurance coverage and regulate the insurance industry. Key provisions include protections for pre-existing conditions and the creation of health insurance marketplaces.

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Healthcare Access

Aging in Place

The ability of older adults to live independently in their homes with necessary support services. Aging in place allows seniors to maintain their routines and comfort while receiving medical or personal care as needed.

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Healthcare Facilities

Assisted Living vs. Nursing Home

Assisted living provides housing and support with daily activities, while nursing homes offer 24/7 medical care for those with serious health conditions. Assisted living is suited for those needing minimal assistance, whereas nursing homes cater to individuals requiring continuous medical supervision.

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Healthcare Facilities

Balance Billing

When a provider bills a patient for the difference between their charge and what the insurance reimburses. Some states have laws protecting patients from balance billing in certain situations.

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Insurance & Billing

Beneficiary

A person who receives benefits from a health insurance plan, Medicare, Medicaid, or other healthcare programs. Beneficiaries include policyholders, dependents, and individuals enrolled in government health programs.

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Insurance & Billing

COBRA Insurance

A program that allows individuals to continue employer-sponsored health coverage after job loss for a limited time. COBRA can be expensive since the individual must pay the full premium, but it provides continuity of care.

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Insurance & Billing

CPR Guidelines

Cardiopulmonary resuscitation (CPR) is a life-saving technique used in emergencies when someone's breathing or heartbeat has stopped. Updated guidelines emphasize hands-only CPR for bystanders to increase survival rates.

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Medical Procedures

Cardiac Rehab

A medically supervised program that helps individuals recover after a heart attack, surgery, or other heart conditions. It includes exercise training, education, and lifestyle changes to improve cardiovascular health.

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Medical Procedures

Catastrophic Health Insurance

A type of health plan designed for young or low-income individuals that covers emergency care and serious medical events. These plans have low premiums but very high deductibles, making them suitable only for worst-case scenarios.

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Insurance & Billing

Charity Care Programs

Hospital and healthcare provider programs that offer free or reduced-cost care to low-income individuals. These programs help ensure that financial hardship does not prevent access to essential medical treatments.

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Insurance & Billing

Coinsurance

The percentage of medical costs a patient must pay after meeting their deductible, such as paying 20% while insurance covers the remaining 80%. Unlike a copay, which is a fixed fee per visit or service, coinsurance is a percentage of the total cost, meaning the patient’s expense varies based on the price of the service.

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Insurance & Billing

Concierge Medicine

A healthcare model where patients pay a membership fee for enhanced access to their doctor, often including longer appointments, same-day scheduling, and more personalized care. This model reduces patient load per physician, allowing for more direct communication and comprehensive management, but it typically operates outside traditional insurance networks.

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Healthcare Services

Coordination of Benefits

A process used when a patient has multiple health insurance policies to determine which insurer pays first. This helps avoid overpayments or gaps in coverage.

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Insurance & Billing

Copayment (Copay)

A fixed amount a patient pays for a covered service, such as $30 for a doctor’s visit, regardless of the total cost of care. Unlike coinsurance, which is a percentage of the total bill and can vary based on the service's price, a copay remains a set fee, making healthcare expenses more predictable.

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Insurance & Billing

Crisis Hotline (988)

A nationwide, three-digit suicide and crisis hotline providing immediate support for individuals experiencing emotional distress. Callers can connect with trained counselors for mental health assistance at any time.

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Chronic Conditions

Deductible

The amount a patient must pay for medical services before insurance starts covering costs. High-deductible plans often have lower premiums but require more upfront spending before coverage kicks in.

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Insurance & Billing

Direct Primary Care (DPC)

A healthcare model where patients pay a flat monthly or annual fee directly to their primary care provider for unlimited visits and services, bypassing traditional insurance. Unlike concierge medicine, DPC generally has lower fees and focuses on affordability, often catering to individuals and families seeking routine care without the complexity of insurance billing.

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Healthcare Services

Do Not Resuscitate (DNR) Order

A medical order stating that a patient does not want CPR if their heart stops. This is commonly used for terminally ill patients who wish to avoid aggressive interventions.

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Patient Rights

Drug Interactions

The effect that occurs when two or more medications, supplements, or substances interact in a way that alters their effectiveness or causes unintended side effects. Some interactions can reduce a drug’s effectiveness, while others may increase the risk of harmful reactions, making it vital for healthcare providers to review a patient’s full medication list.

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Medical Procedures

Drug Side Effects

Unintended reactions that occur when taking a medication, ranging from mild issues like drowsiness or nausea to severe complications such as organ damage or allergic reactions. While some side effects are expected and manageable, others may require adjusting the dosage, switching medications, or stopping treatment altogether.

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Medical Procedures

Durable Medical Equipment (DME)

Medical devices and supplies prescribed for long-term use, such as wheelchairs, oxygen tanks, and diabetic monitors. DME is frequently covered by insurance if deemed medically necessary, but it often needs to meet strict approval guidelines.

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Healthcare Technology

Durable Power of Attorney

A document granting someone legal authority to make healthcare decisions if the patient is incapacitated. This person can make treatment choices on the patient’s behalf.

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Patient Rights

EHR vs. EMR

EHRs (Electronic Health Records) are digital versions of patient records that can be securely shared across multiple healthcare providers and facilities, improving coordination between doctors, hospitals, and specialists. EMRs (Electronic Medical Records) are similar but limited to a single provider’s office or healthcare system, meaning they do not easily transfer between different medical organizations.

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Healthcare Technology

Emergency Room vs. Urgent Care

The ER treats life-threatening conditions, while urgent care is for non-life-threatening but immediate health concerns. Urgent care is often faster and less expensive than the ER.

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Healthcare Facilities

Explanation of Benefits (EOB)

A document sent by insurance companies explaining what medical services were covered, how much was paid, and what the patient owes. EOBs help patients track healthcare costs.

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Insurance & Billing

Fee-for-Service (FFS)

A traditional healthcare payment model where providers are paid per service rendered, rather than through bundled payments. This model can lead to higher costs but allows for greater patient choice.

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Insurance & Billing

Flexible Spending Account (FSA)

A tax-advantaged account that allows employees to set aside pre-tax dollars for eligible healthcare expenses. Unlike HSAs, FSAs often have a "use-it-or-lose-it" rule, requiring funds to be spent within the plan year.

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Insurance & Billing

Food and Drug Administration (FDA) Approvals

The FDA evaluates and approves medications, medical devices, and treatments for safety and effectiveness. This regulatory process ensures that new therapies meet strict health standards before reaching the market.

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Healthcare Technology

Generic vs. Brand-Name Drugs

Generic drugs contain the same active ingredients, dosage, and effectiveness as their brand-name counterparts but are typically sold at a lower cost. While brand-name drugs are developed and marketed by pharmaceutical companies under a patent, generics become available once the patent expires, offering a more affordable alternative with FDA-approved safety and efficacy.

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Medical Procedures

HIPAA (Health Insurance Portability and Accountability Act)

A federal law ensuring patient privacy and the secure handling of health information. HIPAA protects personal medical records from unauthorized access.

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Patient Rights

Health Insurance Marketplace Subsidies

Financial assistance provided under the Affordable Care Act (ACA) to lower the cost of monthly insurance premiums. Subsidies are based on income and help make insurance more accessible for individuals and families.

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Insurance & Billing

Health Policy Reform

Legislative efforts to update healthcare access, affordability, and quality. Health policy changes may address insurance coverage, hospital regulations, or prescription drug pricing.

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Healthcare Access

Health Savings Account (HSA)

A tax-advantaged account used to save for qualified medical expenses, available with high-deductible health plans. Contributions roll over each year, making HSAs a long-term savings tool for healthcare.

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Insurance & Billing

Heat Stroke vs. Heat Exhaustion

Heat exhaustion is a milder condition with symptoms like dizziness and heavy sweating, while heat stroke is a life-threatening emergency that requires immediate medical attention. Heat stroke can cause confusion, unconsciousness, and organ failure.

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Chronic Conditions

High-Deductible Health Plans (HDHPs)

Insurance plans with lower monthly premiums but higher deductibles. HDHPs are often paired with Health Savings Accounts (HSAs) to help cover out-of-pocket expenses.

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Insurance & Billing

Home & Long-Term Care

A broad category of healthcare services designed to support individuals who need ongoing assistance due to aging, chronic illness, or disability. This includes in-home care, assisted living, nursing homes, and hospice, with services ranging from personal care and daily activities to skilled medical treatment, often funded through private pay, insurance, or government programs like Medicaid.

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Healthcare Facilities

Home Health Aide

A trained caregiver who provides in-home assistance with daily activities such as bathing, dressing, and medication reminders. Home health aides support individuals who need help but prefer to remain in their own homes.

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Healthcare Services

Home Health Monitoring

The use of technology to track a patient’s health status remotely. It enables real-time tracking of vital signs and chronic conditions to improve care management.

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Healthcare Technology

Hospice vs. Palliative Care

Hospice is specialized end-of-life care for patients with terminal illnesses, while palliative care provides symptom relief for serious conditions at any stage. Hospice focuses on comfort without curative treatment, whereas palliative care can be provided alongside ongoing medical treatment.

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Healthcare Facilities

Hospital Accreditation (JCAHO)

The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) is an independent, nonprofit organization that evaluates and certifies healthcare facilities based on quality and safety standards. Accreditation from The Joint Commission signifies that a hospital meets rigorous criteria for patient care, infection control, and operational efficiency, which can impact funding, insurance reimbursements, and public trust.

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Healthcare Facilities

Hospital Financial Assistance Programs

Assistance programs offered by hospitals to help uninsured or underinsured patients manage healthcare costs. These programs may include discounts, payment plans, or full coverage for qualifying individuals.

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Insurance & Billing

ICU (Intensive Care Unit)

A specialized hospital unit that provides critical care for patients with life-threatening conditions. ICUs are staffed with specially trained medical professionals and advanced monitoring equipment.

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Healthcare Facilities

Informed Consent

The process of ensuring patients understand and agree to medical procedures and treatments. It includes risks, benefits, and alternative treatment options.

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Patient Rights

Living Will

A document specifying desired medical treatments in end-of-life situations. It guides healthcare providers and family members when making difficult medical choices.

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Patient Rights

Long-Term Care Insurance

Protect your savings and expand care options with long-term care insurance. Learn what it covers, why to consider it and how it works with other coverage.

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Insurance & Billing

Magnet Hospital Status

A designation awarded by the American Nurses Credentialing Center (ANCC) to hospitals that meet high standards for nursing excellence, patient care, and professional development. Magnet hospitals are recognized for lower patient mortality rates, better nurse retention, and improved overall healthcare outcomes, making them highly regarded institutions for both patients and healthcare professionals.

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Healthcare Facilities

Mail-Order Pharmacy

A pharmacy service that delivers prescription medications directly to a patient’s home, often in 90-day supplies, for convenience and cost savings. These pharmacies are typically used for maintenance medications for chronic conditions and may offer lower prices than retail pharmacies, but they require advance planning to account for shipping times.

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Healthcare Services

Medicaid Eligibility

Criteria that determine who qualifies for Medicaid, typically based on income, age, disability, and household size. Eligibility varies by state and is often expanded under federal healthcare programs.

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Healthcare Access

Medicaid Expansion

A provision of the Affordable Care Act (ACA) that allows states to extend Medicaid eligibility to more low-income individuals. Each state decides whether to adopt expansion based on its own policies and healthcare priorities.

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Healthcare Access

Medical Debt Forgiveness

The process of reducing or eliminating outstanding medical bills for patients experiencing financial hardship. Some hospitals, charities, and nonprofit organizations offer debt relief programs for eligible patients.

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Insurance & Billing

Medical Malpractice

When a healthcare provider causes harm to a patient through negligence, errors, or failure to meet the standard of care. This can include misdiagnosis, surgical mistakes, medication errors, or lack of informed consent, and may lead to legal action if the patient suffers significant harm.

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Patient Rights

Medical Power of Attorney

A legal document allowing a designated person to make medical decisions for another individual. It ensures that medical choices align with a patient’s wishes if they become incapacitated.

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Patient Rights

Medicare Advantage (Part C)

A type of Medicare plan offered by private insurance companies that provides an alternative to Original Medicare. These plans bundle Medicare Part A (hospital insurance) and Part B (medical insurance) and often include additional benefits like prescription drug coverage, vision, dental, and wellness programs. However, they may have restricted provider networks, higher out-of-pocket costs for certain services, and stricter prior authorization requirements compared to Original Medicare.

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Insurance & Billing

Medicare Part A

Covers hospital stays, skilled nursing facility care, hospice, and some home healthcare services. Most people do not pay a premium for Part A if they have sufficient work history.

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Insurance & Billing

Medicare Part B

Covers outpatient services, doctor visits, preventive care, and medical supplies. Part B requires a monthly premium and may have additional cost-sharing.

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Insurance & Billing

Medicare Part D

Provides prescription drug coverage for Medicare beneficiaries. Plans vary in coverage and cost, and beneficiaries may face a coverage gap known as the "donut hole."

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Insurance & Billing

Medication Adherence

The extent to which a patient takes their medications as prescribed, including the correct dose, timing, and frequency. Poor adherence—whether due to cost, side effects, or forgetfulness—can lead to worsening health conditions, hospitalizations, and reduced treatment effectiveness.

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Medical Procedures

Medication Reconciliation

The process of reviewing and updating a patient’s complete medication list to ensure accuracy and prevent errors during transitions of care. This helps identify discrepancies, avoid harmful drug interactions, and ensure that providers and patients are aligned on current prescriptions.

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Medical Procedures

Medigap

Private insurance that helps cover out-of-pocket costs not paid by Original Medicare. Policies vary, but they often cover copays, coinsurance, and deductibles.

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Insurance & Billing

Memory Care Facilities

Specialized residential communities designed to support individuals with dementia or Alzheimer’s disease. These facilities provide a secure environment, structured routines, and trained staff to manage cognitive decline.

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Healthcare Facilities

Mental Health Parity Act

A federal law that requires insurance companies to provide equal coverage for mental health and substance use disorder treatments. This ensures that mental health benefits are not more restrictive than medical or surgical coverage.

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Patient Rights

National Institutes of Health (NIH)

The U.S. government's leading medical research agency, responsible for funding and conducting research on diseases and treatments. NIH research contributes to advancements in medical science and public health.

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Healthcare Technology

Network (In-Network vs. Out-of-Network)

A group of healthcare providers contracted with an insurance company. Staying in-network usually results in lower costs, while out-of-network services can lead to higher bills or reduced coverage.

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Insurance & Billing

Nonprofit vs. For-Profit Hospitals

Nonprofit hospitals are tax-exempt institutions that reinvest earnings into patient care, community programs, and facility improvements, often providing charity care for uninsured patients. For-profit hospitals, on the other hand, operate as businesses, distributing profits to shareholders and investors while still delivering medical services, which can sometimes lead to differences in pricing, service availability, and financial priorities.

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Healthcare Facilities

Opioid Addiction Treatment

Medical and behavioral therapies designed to help individuals recover from opioid dependence. Treatment often includes medication-assisted therapy (MAT) with drugs like methadone, buprenorphine, or naltrexone.

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Chronic Conditions

Out-of-Pocket Costs

Expenses that a patient must pay for healthcare services that are not covered by insurance. These can include deductibles, copays, coinsurance, and non-covered services.

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Insurance & Billing

Out-of-Pocket Maximum

The highest amount a patient must pay before insurance covers 100% of covered costs. Once this limit is reached, the insurer pays for all additional covered expenses for the rest of the plan year.

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Insurance & Billing

Over-the-Counter (OTC) Medications

Drugs that can be purchased without a prescription for common conditions like pain, allergies, or cold symptoms. While generally considered safe when used as directed, some OTC medications can interact with prescription drugs or cause side effects if misused.

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Medical Procedures

PET Scan

A medical imaging test that helps detect diseases like cancer and brain disorders. It uses radioactive tracers to visualize changes at a cellular level before structural changes occur.

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Medical Procedures

Palliative Care Consultation

A medical service focused on relieving symptoms and improving quality of life for patients with serious illnesses. It is often used alongside curative treatments to enhance patient comfort.

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Healthcare Facilities

Patients’ Bill of Rights

A set of patient protections ensuring fair and ethical treatment in healthcare settings. It includes the right to informed consent, privacy, and respectful care.

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Patient Rights

Payment Plans for Medical Bills

Arrangements that allow patients to pay off medical expenses over time instead of in one lump sum. Many hospitals and providers offer interest-free plans to make healthcare costs more manageable.

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Insurance & Billing

Pharmacy Benefit Manager (PBM)

A third-party company that negotiates drug prices and manages prescription benefits for insurance companies. PBMs impact medication costs and access to preferred drug formularies.

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Insurance & Billing

Physical Therapy vs. Occupational Therapy

Physical therapy focuses on restoring movement and function after an injury, while occupational therapy helps individuals perform daily tasks despite physical limitations. Both therapies aim to improve quality of life and independence.

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Healthcare Services

Post-Traumatic Stress Disorder (PTSD)

A mental health condition triggered by experiencing or witnessing a traumatic event, leading to symptoms such as flashbacks, anxiety, and emotional numbness. PTSD is commonly treated with therapy, medication, and support groups.

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Chronic Conditions

Premium

The monthly amount a patient pays for health insurance coverage. This cost is required to maintain coverage regardless of whether medical services are used.

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Insurance & Billing

Prescription Drug Formularies

A list of medications covered by a health insurance plan, organized into tiers that determine out-of-pocket costs. Lower-tier drugs, such as generics, are usually more affordable, while higher-tier or non-formulary drugs may require higher copays or prior authorization.

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Insurance & Billing

Preventive Screenings (e.g., Mammograms, Colonoscopy)

Routine medical tests used to detect diseases early before symptoms appear. These screenings help identify conditions like cancer or heart disease when treatment is most effective.

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Medical Procedures

Primary Care Physician (PCP)

A doctor who provides general medical care and manages overall patient health. They coordinate specialist referrals and ongoing preventive care. The term is often used interchangeably with "primary care provider," though the latter may also include nurse practitioners (NPs) and physician assistants (PAs).

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Healthcare Services

Primary Care Provider (PCP)

A healthcare professional who serves as the main point of contact for a patient’s medical care. PCPs coordinate treatment plans, preventive care, and specialist referrals.

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Healthcare Services

Prior Authorization

A process requiring approval from the insurer before certain medical services or medications are covered. This is often required for expensive treatments to ensure medical necessity and cost control.

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Insurance & Billing

Prior Authorization for Medications

A requirement by insurance companies for healthcare providers to obtain approval before prescribing certain medications. This process is intended to control costs and ensure medical necessity but can delay access to treatment and require additional paperwork from both patients and providers.

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Insurance & Billing

Public Health Emergency (PHE)

A government-declared event that allows for temporary healthcare policy changes and emergency responses, such as during pandemics or natural disasters. PHE declarations can increase funding and healthcare access.

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Healthcare Access

Remote Patient Monitoring

The use of digital devices to track a patient's health conditions from home. This allows healthcare providers to monitor vital signs, medication adherence, and chronic diseases remotely.

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Healthcare Technology

Respite Care

Temporary relief for primary caregivers by arranging short-term care for a dependent individual. This service helps prevent caregiver burnout and ensures continuous, high-quality care for the patient.

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Healthcare Facilities

Rural Healthcare Access

The availability of medical services in remote and underserved areas. Challenges in rural healthcare include fewer providers, longer travel times, and limited specialty care options.

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Healthcare Access

Single-Payer Healthcare

A system in which the government provides universal health coverage by funding healthcare through taxes. Single-payer models eliminate private insurance and standardize care across all citizens.

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Healthcare Access

Skilled Nursing Facility (SNF)

A healthcare facility providing short-term rehabilitation or long-term nursing care for patients recovering from illness, injury, or surgery. SNFs offer services such as physical therapy, wound care, and medication management under medical supervision.

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Healthcare Facilities

Sliding Scale Fees

A pricing system where medical service costs are adjusted based on a patient’s income. This makes healthcare more affordable for individuals with lower earnings who may not qualify for insurance assistance.

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Insurance & Billing

Smoking Cessation Programs

Programs designed to help individuals quit smoking through counseling, medications, and behavioral support. These may be offered by employers, healthcare providers, or public health organizations.

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Chronic Conditions

Social Security Disability Insurance (SSDI)

A federal program that provides financial benefits to individuals who are unable to work due to a severe disability. SSDI eligibility is based on work history and disability status.

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Insurance & Billing

Specialist vs. General Practitioner

A specialist focuses on a specific area of medicine, while a general practitioner provides broad medical care. Specialists often require referrals from a primary care doctor.

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Healthcare Services

Specialty Pharmacy

A specialist focuses on a specific area of medicine, while a general practitioner provides broad medical care. Many insurance plans, particularly HMOs, require referrals to specialists, especially when a patient needs advanced diagnosis or treatment beyond a primary care provider’s expertise.

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Healthcare Services

Substance Use Disorder (SUD)

A medical condition in which a person’s use of alcohol or drugs leads to health problems, disability, or inability to meet responsibilities. Treatment options include therapy, medication-assisted treatment, and support groups.

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Surprise Billing

Unexpected medical bills from out-of-network providers, often received after emergency care or surgery. The No Surprises Act aims to limit this practice and protect patients from excessive charges.

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Insurance & Billing

Teaching Hospital

A hospital affiliated with a medical school that provides clinical training for medical students, residents, and other healthcare professionals. These hospitals often conduct research, offer specialized treatments, and may have cutting-edge medical technology, but patients may receive care from both experienced doctors and supervised trainees.

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Healthcare Facilities

Telehealth Services

Remote healthcare services delivered through video calls, phone consultations, or secure messaging, allowing patients to connect with providers without an in-person visit. Telehealth is commonly used for routine check-ups, mental health therapy, medication management, and chronic disease monitoring, improving access to care, especially in rural or underserved areas.

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Healthcare Technology