Medical Reference Manual Acronyms | Summaries Voice

Premera Reference Manual

Premera Blue Cross Blue Shield of Alaska

023700 (10-2011)

Acronyms

Chapter 13 ― Page 1

ACF Ambulatory Care Facility

ACR Adjusted Community Rating

ADA Americans with Disabilities Act

ADLs Activities of Daily Living

AFDC Aid to Families with Dependent

Children

AHA American Hospital Association

AHC Alternative Healthcare

AHRQ Agency for Healthcare Research and

Quality

ALOS Average Length of Stay

AMA American Medical Association

ANSI American National Standards Institute

APC Ambulatory Payment Classifications

APG Ambulatory Patient Group

ARNP Advanced Registered Nurse

Practitioner

ASC Ambulatory Surgery Center

ASO Administrative Services Only

ASP Average Sales Price

ASR Age/Sex Rate

AWP Average Wholesale Price

BA Benefit Advisory

BCBSA Blue Cross Blue Shield Association

BDCT Blue Distinction Centers for

Transplants

CAHPS®

CCI Corrective Coding Initiative

Consumer Assessment of Healthcare

Providers Systems

CHAMPUS Civilian Health and Medical Program

of the Uniformed Services

CLIA Clinical Laboratory Improvement Act

CMC Care Management Coordinator

CMHC Community Mental Health Centers

CMS Centers for Medicare and Medicaid

Services (formerly HCFA)

CMS-1500 Billing form for professional services

(formerly called HCFA-1500)

CMT Chiropractic Manipulative Treatment

COB Coordination of Benefits

COBRA Consolidated Omnibus Budget

Reconciliation Act

CM Care Management (department)

CPT (Physician’s) Current Procedural

Terminology

CQ Clinical Quality (department)

CQI Continuous Quality Improvement

CRNA Certified Registered Nurse Anesthetist

CSO Community Service Office

CSW Clinical Social Worker

DAW Dispense as Written

DC Doctor of Chiropractic Medicine

DCI Duplicate Coverage Inquiry

DCO Directive Change Order

DDS Doctor of Dental Surgery

DHHS Department of Health and Human

Services, or HHS

DM Disease Management

DME Durable Medical Equipment

DO Doctor of Osteopathy

DOB Date of Birth

DOH Department of Health

DOS Date of Service

DPM Doctor of Podiatric Medicine

DRG Diagnosis Related Group

DSM-IV Diagnostic and Statistical Manual, 4th

Edition

DX Diagnosis

E&M, E/M Evaluation and Management

EAP Employee Assistance Program

EBM Evidence Based Medicine

ECC Electronic Claims Clearinghouse

EDI Electronic Data Interchange

EIN Employer Identification Number

EMR Electronic Medical Record

EOB Explanation of Benefits

EOP Explanation of Payment

EOC Evidence of Coverage

EOI Evidence of Insurability

EOM End of Month

EOMB Explanation of Medicare Benefits

EOY End of Year

EPSDT Early and Periodic Screening,

Diagnosis and Treatment

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Premera Blue Cross Blue Shield of Alaska

023700 (10-2011) Acronyms Chapter 13 ― Page 1

1133 AcAcrroonnyymmss

ACF Ambulatory Care Facility ACR Adjusted Community Rating ADA Americans with Disabilities Act ADLs Activities of Daily Living AFDC Aid to Families with Dependent Children AHA American Hospital Association AHC Alternative Healthcare AHRQ Agency for Healthcare Research and Quality ALOS Average Length of Stay AMA American Medical Association ANSI American National Standards Institute APC Ambulatory Payment Classifications APG Ambulatory Patient Group ARNP Advanced Registered Nurse Practitioner ASC Ambulatory Surgery Center ASO Administrative Services Only ASP Average Sales Price ASR Age/Sex Rate AWP Average Wholesale Price BA Benefit Advisory BCBSA Blue Cross Blue Shield Association BDCT Blue Distinction Centers for Transplants CAHPS®

CCI Corrective Coding Initiative

Consumer Assessment of Healthcare Providers Systems

CHAMPUS Civilian Health and Medical Program of the Uniformed Services CLIA Clinical Laboratory Improvement Act CMC Care Management Coordinator CMHC Community Mental Health Centers CMS Centers for Medicare and Medicaid Services (formerly HCFA) CMS-1500 Billing form for professional services (formerly called HCFA-1500) CMT Chiropractic Manipulative Treatment COB Coordination of Benefits COBRA Consolidated Omnibus Budget Reconciliation Act

CM Care Management (department) CPT (Physician’s) Current Procedural Terminology CQ Clinical Quality (department) CQI Continuous Quality Improvement CRNA Certified Registered Nurse Anesthetist CSO Community Service Office CSW Clinical Social Worker DAW Dispense as Written DC Doctor of Chiropractic Medicine DCI Duplicate Coverage Inquiry DCO Directive Change Order DDS Doctor of Dental Surgery DHHS Department of Health and Human Services, or HHS DM Disease Management DME Durable Medical Equipment DO Doctor of Osteopathy DOB Date of Birth DOH Department of Health DOS Date of Service DPM Doctor of Podiatric Medicine DRG Diagnosis Related Group DSM-IV Diagnostic and Statistical Manual, 4th Edition DX Diagnosis E&M, E/M Evaluation and Management EAP Employee Assistance Program EBM Evidence Based Medicine ECC Electronic Claims Clearinghouse EDI Electronic Data Interchange EIN Employer Identification Number EMR Electronic Medical Record EOB Explanation of Benefits EOP Explanation of Payment EOC Evidence of Coverage EOI Evidence of Insurability EOM End of Month EOMB Explanation of Medicare Benefits EOY End of Year EPSDT Early and Periodic Screening, Diagnosis and Treatment

Premera Blue Cross Blue Shield of Alaska

Acronyms Chapter 13 ― Page 2

ERISA Employee Retirement Income Security Act of 1974 ESRD End Stage Renal Disease FEP Federal Employee Plan FFS Fee-for-Service FSA Flexible Spending Account FQHC Federally Qualified Health Clinic GEMs General Equivalency Map for ICD- GPCI Geographic Practice Cost Index HCA Health Care Authority HCDS Health Care Delivery Systems HCPCS Healthcare Common Procedure Coding System HEDIS®

HHA Home Health Agency

Healthcare Effectiveness Data and Information Set

HIPAA Health Insurance Portability and Accountability Act HME Home Medical Equipment HMO Health Maintenance Organization HPIN Health Plan Identifier HSA Health Savings Account HRA Health Reimbursement Arrangement IBNR Incurred But Not Reported ICD-9-CM International Classification of Diseases, 9th Edition, Clinical Modification ICD-10-CM Clinical Modification ICD-10-PCS Procedure Coding System IOM Institute of Medicine ICF Intermediate Care Facility IPA Individual Practice Association IVR Interactive Voice Response JCAHO Joint Commission on Accreditation of Healthcare Organizations LCP Licensed Clinical Psychologist LMP Last Menstrual Period LCSW Licensed Clinical Social Worker LOA Letter of Agreement LOS Length of Stay LPC Licensed Professional Counselor LTACH Long term acute care hospital LWOR LifeWise Health Plan of Oregon (Affiliate Company) LWWA LifeWise Health Plan of Washington (Affiliate Company) MAA Maximum Allowed Amount MAA Medical Assistance Administration MD Medical Doctor MDC Major Diagnostic Category MH/SA Mental Health/Substance Abuse

MIS Management Information System MRI Magnetic Resonance Imaging MSA Medical Savings Account MSS Medical Social Services MSW Master’s in Social Work NASCO National Account Service Company NCQA National Committee for Quality Assurance NDC National Drug Code Non-par Non-participating (physician, provider or facility) NPDB National Practitioner Data Bank NOC Not Otherwise Covered or Not Otherwise Classified NPI National Provider Identifier OCR Optical Character Recognition OIC Office of the Insurance Commission Other Insurance Coverage OOA Out-of-Area OSHA Occupational Safety and Health Administration OTC Over-the-counter PT Physical Therapy P&T Pharmacy and Therapeutics PA Physician’s Assistant PAC Pre-admission Certification Par Participating (physician, practitioner or facility) PBM Pharmacy Benefit Manager PCP Primary Care Physician/Provider PEBB Public Employees Benefits Board PFFS Private Fee for Service PIC Personal Identification Code PMG Primary Medical Group PNA Provider Network Associate PNE Provider Network Executive PNR Provider Network Representative PHI Personal Health Information PIC Personal Identification Code PPACA Patient Protection and Affordable Care Act, also ACA (Accountable Care Act) PPI Protected Personal Information POS Place of Service or Point of Service PPO Preferred Provider Organization PRO Peer Review Organization QA Quality Assurance QI Quality Improvement R&C Reasonable and Customary RAPP Regional Advisory Physician Panel RBRVS Resource Based Relative Value Scale

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Medical Reference Manual Acronyms, Summaries of Voice

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Download Medical Reference Manual Acronyms and more Summaries Voice in PDF only on Docsity!

Premera Blue Cross Blue Shield of Alaska

1133 AcAcrroonnyymmss

Premera Blue Cross Blue Shield of Alaska