Starting to Understand the Language of Health Insurance

Part 1: The Basic Tools, Chapter 2: Understanding the Language of Health Insurance Page 1

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All fields have a technical language of their own. In order to follow a conversation between attorneys, biologists, chemists, engineers, or automobile mechanics, you need to be able to understand the technical terminology used in those fields. That's true of the health insurance field, as well. In fact, the health insurance field has developed a highly specialized, technical language all its own. In order to deal with health insurance problems effectively, you'll need to understand that language.

These days, communication among consumers and doc tors, hospitals, laboratories, health insurance companies, and government agencies is often conducted by mail, with few opportunities to ask for explanations. That makes the need to understand the technical language of health insurance even more important. In this chapter we'll review a number of tech nical terms and phrases that are frequently used in communi cations between insurers and consumers.

Technical Terms Used In Claim Processing

Several years ago, I dealt with a problem in which an insur ance company had denied a series of claims for the treatment of depression. The claims covered a number of sessions with a psychiatrist. The bills amounted to more than a thousand dollars, and additional sessions had already been scheduled.

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