1099
IRS Tax Form for Miscellaneous Income
A/R
Accounts Receivables
AAMC
Association of American Medical Colleges
AAPCC
Adjusted Average Per Capita Cost
AAU
Administrative Appeal Unit
ABAWD
Able Bodied Adults Without Dependents
ABD
Acquired Brain Disorder
ACE
Angiotensin-Converting Enzyme (ACE Inhibitors)
ACF
Administration for Children & Families
ACF/OFA
ACF/Office of Family Assistance
ACG
Ambulatory Care Group
ACIP
Advisory Committee on Immunization Practices
Conduent
1) Ambulatory Care Sensitive 2) Conduent, Inc.
ADA
1) American Dental Association 2) Americans with Disabilities Act
ADD/ADHD
Attention Deficit Disorder/Attention Deficit Hyperactivity Disorder
ADE
Adverse Drug Event
ADL
Activities of Daily Living
AG
Assistance Group
AGPA
American Group Practice Association
AHA
American Hospital Association
AHCPR
Agency for Health Care Policy Research
AHFS
American Hospital Formulary Service
AHP
Accountable Health Plan
AIDS
Acquired Immunodeficiency Syndrome
AKA
Also Known As
ALOS
Average Length of Stay
AMA
American Medical Association
AMBSC
Ambulatory Surgical Center
AMDC
Adult Medical Day Care
AMIK
Acute Myocardial Infarction
AMP
Average Manufacturer Price
AMZ
Amortization
ANSI
American National Standards Institute
ANSI X12
HIPAA Electronic Transaction Standard
AO
Administrative Offset
AOM
Acute Otitis Media
AP
Accounts Payable
APA
American Pharmaceutical Association
APC
Ambulatory Payment Classifications
APHSA
American Public Human Services Association
APS
Adult Psychiatric Services
APTD
Aid to the Permanently and Totally Disabled
APWA
American Public Welfare Association
AR
1) Accounts Receivable 2) Authorized Representative
ARNP
Advanced Registered Nurse Practitioner
ASC
Ambulatory Surgical Center
ASCII
American Standard Code for Information Interchange
ASHP
American Society of Hospital Pharmacists
ASIM
American Society of Internal Medicine
ASO
Administrative Services Organization
ATT
Attachment
AVR
Automated Voice Response
AVRS
Automated Voice Response System
AWP
Average Wholesale Price
BC
Breast Cancer
BEER
Beneficiary Earnings Exchange Record
BLSR
Bureau of Labor Statistics
BNA
Bureau of National Affairs
BOA
Bureau of Accounts
BOE
1) Basis of Eligibility 2) Basis of Estimate
BP
1) Behavior Patterns 2) Benefit Plan
BPH
Benign Prostatic Hyperplasia
CAHPS
Consumer Assessments of Health Plans Study
CARE
Comprehensive AIDS Resources Emergency Act
CAST
Cancer Screening & Tracking System
CATCH
Community Access To Child Health
CBA
Cost Benefit Analysis
CBE
Common Base Event
CBO
Congressional Budget Office
CBT
Computer Based Training
CC
1) Care Coordination 2) Cervical Cancer
CCDBC
Child Care Development Block Grant
CCN
Cash Control Number
CCR
Cost-to-Charge Ratio
CD
Compact Disc
CDC
Centers for Disease Control & Prevention
CDROM
Compact Disk Read-Only Memory
CDT
Current Dental Terminology
CFR
Code of Federal Regulations
CHAMPUS
Civilian & Medical Program of Uniformed Services
CHC
Community Health Center
CHCBP
Continued Health Care Benefit Program
CHIP
Children's Health Insurance Program
CHPA
Community for Health Purchasing Alliance
CHPP
Center for Health Plans & Providers
CI
Confidence Interval
CIP
Catastrophic Illness Program
CLAIMIP
Claim Inpatient
CLAIMLT
Claim Long Term
CLAIMRX
Claim Pharmacy
CLCR
Claims Reports
CLIA
Clinical Laboratory Improvements Amendment
CMD
Carrier Medical Director
CMN
Certificate of Medical Necessity
CMP
Competitive Medical Plan
CMS
Centers for Medicare and Medicaid Services
CMS-2082
Annual Report to CMS
CMS-25
Medicaid Program Budget Report
CMS-372
Annual Report on Home and Community
CMS-416
Annual EPSDT Participation Report
CMS-64
Quarterly Medicaid Statement of Expenditures for the Medicaid Assistance Program
CMSO
Center for Medicaid & State Operations
CN
Categorically Needy
COA
Category of Assistance
COB
Coordination of Benefits
COBA
Coordination of Benefits Agreement
COBC
Coordination of Benefits Contractor
COBRA
Consolidated Omnibus Budget Reconciliation Act
COE
Category of Eligibility
COLA
Cost of Living Adjustment
COLD
Computer Output Laser Disk
COLD-ERM
Computer Output Laser Disk - Enterprise Report Management
COS
Category of Service
CPA
Certified Public Accountant
CPI
Consumer Price Index
CPU
Central Processing Unit
CR
Client Registration
CRAHCA
Center for Research in Ambulatory Health Care Administration
CRN
Correspondence Record Number
CS
Client Services
CSD
Children with Severe Disabilities
CSE
Child Support Enforcement
CSLA
Community Supported Living Arrangements
CSPIA
Child Support Performance & Incentive Act of 1998
CSR
1) Customer Service Request 2) Customer Service Representative
CWLA
Child Welfare League of America
CWS
Child Welfare Services
D RC
Group Utility Code
DAS
Department of Administrative Services
DB
Database
DBA
1) Doing Business As 2) Database Administrator
DCG
Diagnostic Care Group
DCN
Document Control Number
DD
Developmentally Disabled
DDU
Disability Determination Unit
DEA
Drug Enforcement Agency
DEERS
Defense Enrollment Eligibility Reporting System
DES
1) Drug Effectiveness Source 2) Data Encryption Standard
DESI
Drug Effectiveness Source Identifier
DHHS
Department of Health and Human Services
DHR
Digital Health Record
DMARD
Disease-Modifying Anti-Rheumatic Drug
DME
Durable Medical Equipment
DMV
Division of Motor Vehicles
DMZ
Demilitarized Zone
DO
1) Doctor of Osteopathy 2) District Office
DOB
Date of Birth
DOD
Date of Death
DOS
Date of Service
DRA
1) Deficit Reduction Act 2) Department of Revenue
DRG
Diagnostic Related Group(ing)
DSM
Disease State Management
DTC
Direct-To-Consumer
DX
Diagnosis
EB
Eligibility Information
EBT
Electronic Benefit Transfer
ECC
Electronic Claims Capture
ECI
Elderly & Chronically Ill
ECM
Electronic Claims Management
ECS
Electronic Claims Submission
EDI
Electronic Data Interchange
EDP
Electronic Data Processing
EDSG
Electronic Data Sharing Gateway
EFT
1) Electronic Funds Transfer 2) Electronic File Transfer
EITC
Earned Income Tax Credit
EKG
Electrocardiogram
EOB
Explanation of Benefits
EOMB
Explanation of Medical Benefits
EOP
Explanation of Prescriptions
EPO
Exclusive Provider Organization
EPSDT
Early and Periodic Screening, Diagnosis and Treatment Services
ERC
Error Return Codes
ERISA
Employment Retirement Income Security Act
ESC
Error Status Code
ESRD
End State Renal Disease
ETS
Enrollment Tracking System
EV
Eligibility Verification
FAFB
Federal Assistance Financing Branch
FAP
Family Assistance Program
FAQ(s)
Frequently Asked Question(s)
FC
Foster Care
FCN
Financial Control Number
FDA
Food & Drug Administration
FDOS
1) First Date of Service 2) From Date of Service
FECA
Federal Employees' Compensation Act
FEHBP
Federal Employee Health Benefits Program
FEIN
Federal Employer Identification Number
FFS
Fee for Service
FFY
Federal Fiscal Year - Extends from October 1 through September 30 of the following calendar year
FFYQ
Federal Fiscal Year Quarter
FHSC
First Health Services Corporation
FIFO
First In First Out
FIPS
Federal Information Processing Standards
FMAC
Federal Maximum Allowable Cost
FMAP
Federal Medical Assistance Payment or Percentage
FN
First Name
FNS
Food & Nutrition Service
FP
Family Planning
FPL
Federal Poverty Level
FQHC
Federally Qualified Health Centers
FS
Fee Schedule
FSS
Family Service Specialist
FTP
File Transfer Protocol
FTP(S)
File Transfer Protocol (Secure Socket)
FY
Fiscal Year
FYE
Fiscal Year End
GB
Gigabyte
GCN
Generic Code Numbers
GCR
Global Clinical Record
GHAA
Group Health Association of America
GHI
Also known as Coordination of Benefits Agreement (COBA)
GIS
Geographical Information System
HB
House Bill
HBOC
HBO and Company
HBRHC
Hospital Based Rural Health Clinic
HCFA
Health Care Financing Administration
HCPC
Health Care Provider Code
HCPP
Health Care Prepayment Plan
HCQIP
Health Care Quality Improvement Program
HEDIA
Health Plan Employer Data and Information System
HHA
Home Health Agency
HHS
Health and Human Services
HIAA
Health Insurance Association of America
HIC
1) Health Insurance Control Number (Medicare ID Number) 2) Health Insurance Claim 3) Hierarchical Ingredient Code
HICN
Health Insurance Claim Number
HIPAA
Health Insurance Portability and Accountability Act of 1996
HIPP
Health Insurance Premium Payment
HIS
1) In-Home Services 2) Health Information Standards
HIV
Human Immunodeficiency Virus
HMO
Health Maintenance Organization
HOH
Head of Household
HPR
Hospital Peer Review
HPSA
Health Professional Shortage Area
HRPC
Human Resource Profile Code
HRSA
Human Resources and Services Administration
HTML
Hypertext Markup Language
HTTP
Hypertext Transfer Protocol
HTTPS
Hypertext Transfer Protocol over Secure Socket
IADL
Instrumental Activities of Daily Living
IBNR
Incurred But Not Reported
IBXR
Inpatient Part B Crossover
ICD
International Classification of Diseases
ICF
Intermediate Care Facility
ID
Identification Number
IDEA
Individuals with Disability Education Act
IE
Internet Explorer
IEVS
State Income and Eligibility Verification System
IG
Inspector General
IHS
1) In-Home Services 2) Indian Health Services
IMD
Institution of Mental Disease
IMR
Infant Mortality Rate
IND
Indicator
INS
Immigrations and Naturalization Services
IOMD
Institution of Mental Disease
IOP
Intensive Outpatient (treatment)
IP
1) Inpatient 2) Internet Protocol 3) In-process
IPA
International Pharmaceutical Abstracts 2) Individual Practice Association
IRS
1) Internal Revenue Service 2) Identical, Related or Similar Drugs
ISP/ASP
Internet Service Provider/Application Service Provider
IT
Information Technology
IV
Intravenous
IV&V
Independent Verification and Validation
IVE
Child Welfare Services Foster Care Title IV-E
IVRS
Integrated Voice Response System
JOBS
Jobs Opportunities and Basic Skills Training Program
JTPA
Job Training Partnership Act
LDOS
Last Date of Service
LEP
Limited English Proficiency
LI
1) Line Item 2) Line Number
LLC
1) Limited Liability Company 2) Legal Liable County
LN
1) Last Name 2) Line Number
LOB
Line of Business
LOC
Level of Care
LOS
Length of Stay
LPN
Licensed Practical Nurse
LT
Long Term
LTC
Long Term Care
MA
Medical Assistance
MA ID
Medical Assistance/Medicaid Identification
MAC
Maximum Allowable Cost
MAO
Medical Assistance Only
MAP
Medical Assistance Payments
MAS
Maintenance Assistance Status
MB
Megabyte
MBD
Medicare Beneficiary Database
MBI
Medicare Beneficiary Identifier
MCC
Medical Care Coverage
MCCA
Medicare Catastrophic Coverage Act
MCO
Managed Care Organization
MCS
Medicaid Client Services
MCSYS
Managed Care System
MDC
Major Diagnostic Category
MHZ
Megahertz
MI
Middle Initial
MIC
Medicaid Carrier ID
MID
Medicaid Identification Number
MITA
Medicaid Information Technology Architecture
MMA
Medicare Modernization Act
MMIS
Medicaid Management Information System
MMPPPA
Medicare & Medicaid Patient Program Protection Act
MN
Medically Needy
MOB
Monthly Obligation Balance
MODEM
Modulation-DEModulation
MQ
Mammography Quality
MQGE
Medicare Qualified Government Employee
MQIP
Medicaid Quality Incentive Program
MQSA
Mammography Quality Standards Act
MR
1) Mental Retardation 2) Member Representative
MRT
Medical Review Team
MSA
Medical Savings Account
M-SCHIP
M-State Children's Health Insurance Program
MSI
Meds Solutions, Incorporated
MSIS
Medicaid Statistical Information System
MSM
Monthly Summary Record
MSO
Management Service Organization
MSQ
Medical Service Questionnaire
MSRP
Manufacturer's Suggested Retail Price
MTD
Month to Date
NABP
National Association Board of Pharmacies
NACDS
National Association of Chain Drug Stores
NAHC
National Association for Home Care
NAIC
National Association of Insurance Commissioners
NASMD
National Association of Medicaid Directors
NCP
Non Custodial Parent
NCPDP
National Council for Prescription Drug Programs
NCQA
National Committee for Quality Assurance
NCVHS
National Committee on Vital Health Statistics
NDC
National Drug Code
NECSRS
National Electronic Child Support Resource System
NEMI
National Medicaid EDI HIPAA workgroup
NEMT
Non-Emergency Medical Transportation
NF
Nursing Facility - A long-term care facility licensed under State law and certified by Medicare to provide skilled and intermediate levels of care
NFQA
Nursing Facility Quality Assessment
NLM
National Library of Medicine
NMSN
National Medical Support Notice
NOS
Not Otherwise Specified
NPI / NPID / NPIN
1) National Payer ID 2) National Provider Information Number
NPS
National Provider System
NSAID
Non-Steroidal Anti-Inflammatory Drug
NTI
Narrow Therapeutic Index
NUBC
National Uniform Billing Committee
NUCC
National Uniform Claim Committee
OAA
Old Age Assistance
OBRA
Omnibus Budget Reconciliation Act
OCAA
Omnibus Consolidated Appropriations Act
OCD
Obsessive Compulsive Disorder
OCR
Optical Character Recognition
ODB
Office of Drug Pricing
ODPHP
Office of Disease Prevention and Health Promotion
OIG
Office of Inspector General
OMB
Office of Management and Budget
OPPS/APC
Outpatient Prospective Payment System/APC Ambulatory Payment Class
ORA
Office of Research and Analysis
OrgID
Organization Identifiers
OS
Operating System
OT
Occupational Therapy
OTP
One Time Payment
PA
Prior Authorization
PAC
Pricing Action Code
PACE
Program of All-inclusive Care for the Elderly
PARCA
Patient Access to Responsible Care Act of 1997
PC
Personal Computer
PCA
Personal Care Assistant
PCCM
Primary Care Case Management
PCP(s)
Primary Care Physician(s)
Pd
Paid
PDF
Portable Document Format
PDL
Preferred Drug List
PERS
Public Employee Retirement System
PHI
Protected Health Information
PHO
Physician-Hospital Organization
PHP
Prepaid Health Plan
PII
Personal Identifiable Information
PIN
Personal Identification Number
PIP
1) Physician Incentive Plan 2) Periodic Interim Payment
PLC
Poverty Level Children
PMC
Per Month Charge Per Use
PMPM
Per Member Per Month
PNA
Personal Needs Allowance
PNMI
Private Non-Medical Institution
POC
Point of Contact - The single person representing an organization who is the point of contact for all questions or comments
POS
1) Place of Service 2) Point of Service
PP
Provider Payment
PPG
Performance Partnership Grant
PPI
Provider Pricing Indicator
PPO
Preferred Provider Organization
PPRC
Physician Payment Review Commission
PPTs
PowerPoints
PRWORA
Personal Responsibility and Work Opportunity Recon Act
PSU
Per Service Unit
PT
Per Transaction
PTA
Part A (Third Party)
PTS
Patients
PV
Payment Voucher
PWD
Password
PWE
Principal Wage Earner
QA
Quality Assurance
QDWI
Qualified Disabled Working Individual
QI
Qualifying Individual
QIP
Quality Improvement Plan
QMB
Qualified Medicare Beneficiary
QMR
Quality MQIP Returns
QWDI
Qualified Working Disabled Individual
RA
Remittance Advice
RAVEN
Resident Assessment Validation and Entry
RCC
Revenue Center Code
REBA
Recipient Base (Screen)
REOMB
Recipient Explanation of Medical Benefits
RFA
Request for Assistance
RFI
Request for Information
RHC
Rural Health Clinic
RN
Registered Nurse
RRB
Railroad Retirement Board
RSN
Reason
RTP
Returned To Provider
RWJF
Robert Wood Johnson Foundation
RX
Prescription
SA
Service Authorization
SACWIS
Statewide Automated Child Welfare Information System
SB
Senate Bill
SCHIP
State Children's Health Insurance Program
SG
Study Group
SHCH
State Healthcare Clearinghouse
SIPP
Survey of Income Program Participation
SLMB
Specified/Special Low Income Medicare Beneficiary
SMA
State Medicaid Agency
SMAC
State Maximum Allowable Cost
SMDA
State Medicaid Directors' Association
SMM
State Medicaid Manual
SMSA
Standard Metropolitan Statistical Areas
SNF
Skilled Nursing Facility
SSA
Social Security Administration
SSDI
Social Security Disability Insurance
SSI
Supplemental Security Income
SSL
Secure Socket Layer
SSN
Social Security Number
SSO
Single Sign On
STS
Special Transit Services
TANF
Temporary Assistance for Needy Families
TBD
To Be Determined
TCN
Transaction Control Number
TCP/IP
Transmission Control Protocol/Internet Protocol
TDD
Telecommunication Device for Deaf
TDOS
1) To Date of Service 2) Through Date of Service
TEFRA
Tax Equity and Fiscal Responsibility Act
TOB
Type of Bill
TOC
Table of Contents
TOD
Time of Day
TOS
Type of Service
TPL
Third Party Liability
TPL A & T
Third Party Liability Accident and Trauma
TTY
Telephone Typewriter
TXN
Transaction
TXT
Text File
UB-92
CMS standard hospital and nursing home paper billing form
UIB
Unemployment Insurance Benefits
Undup
Unduplicated
UOS
Units of Service
UPIN / UPN
Universal Provider Number
UPS
1) Uninterruptible Power Supply 2) United Parcel Service
URA
Universal Provider Number
URL
Universal Resource Locator
USC
United States Code
VPN
Virtual Private Network
VRU
Voice Response Unit
W3C
World Wide Web Consortium
W-9
Request for Taxpayer Identification Number
WAC
Wholesale Average Cost
WAN
Wide Area Network
XLS
Microsoft Excel File
XML
Extensible Markup Language
YTD
Year-to-Date