GLOSSARY OF FREQUENTLY USED HEALTH CARE/PASSPORT

ACRONYMS AND TERMS

September 2011

PASSPORT GLOSSARY September 2011

GLOSSARY OF FREQUENTLY USED HEALTH CARE/PASSPORT ACRONYMS AND TERMS

277CA
5010
999
A08
AAA
AAC
AAHAM
AAHP
A/B MAC
ABN
ACA
ACE
ACH
ACK
ACO
ACPOE
ACROFILE
ACF
ACS
ACT
ADA
ADBS
ADE
ADI
ADIC
ADR
ADS
ADT
AES
AF
AFD
AFDC
AFN
AHA
AHIC
AHCA
AHIMA
AHIP
AHRQ
AIS
AIU
AJAX
AKL
ALF
ALJ
ALOS
AMA
AMIA
AMMF
AMP

Healthcare Claim Acknowledgement (See X12 277CA)

ASC X12 version 5010 and NCPDP version D.0 (See ANSI X12 5010)
Implementation Acknowledgement (See X12 999)
HL7 Update Patient Registration Message
Abdominal Aortic Aneurysm
Average Allowable Cost (EHR Technology)
American Association of Healthcare Administrative Management
See AHIP
Medicare Administrative Contractor (Replacement for Medicare FI/Carrier System)
Advance Beneficiary Notice of Non Coverage (ABN)
Affordable Care Act
Access Control Entry
Automated Clearing House
Acknowledgement Packet
Accountable Care Organization
Ambulatory Computerized Physician Order Entry
Complete Consumer Credit Report (EQUIFAX)
Administration for Families and Children
Automated Claims Status
Automated Collection Transactions (EFX Batch Credit Report)
American Dental Association
Automated Daily Batch Submission
Adverse Drug Event
Advanced Diagnostic Imaging
Ambulatory Diagnostic Imaging Center (Independent Radiology)
Additional Development/Documentation Request
Automated Development System (Medicare)
Admission Discharge & Transfer
Advanced Encryption Standard
Administrative Fee
Automated Fuel Transaction (Visa)
Aid to Families With Dependent Children
Accumulation File Number (Medicare)
American Hospital Association
American Health information Community
American Healthcare Association
American Health Information Management Association
Americas Health Insurance Plans
Agency for Healthcare Research & Quality
Atlantic Information Services
Adopt, Implement, Upgrade, (Certified EHR Technology)
Asynchronous Java Script & XML
Federal Anti-Kickback Legislation
Assisted Living Facility
Administrative Law Judge
Average Length of Stay
American Medical Association
American Medical Informatics Association
Acquirer Merchant Master File (VISA)
Access Management Platform

PASSPORT GLOSSARY September 2011

ANSI
ANSI X12 5010
AOB
AOC
APC
APDRG
APG
API
AP
APP
APTA
A/P
A/R
ARDEN Syntax
ARRA
ASC
ASCII
ASO
ASCP
ASP
ASP.Net
ASR
ASTM
ASV
ATM
ATP
AUP
AUTHORIZATION
AV
AVS
AWP
AWV
B2B
B2C
BA
BAA
BA/R
BBA
BBG
BBRA
BCBS
BCP
BI
BI
BIA
BIN
BIOS
BIPA
BNI
BOC
BS
Carrier

American National Standards Institute Approved standards developing

organization in Healthcare arena
Updated Version of the current 4010 Medical Transaction Standard
Assignment of Benefits
Attestation of Compliance
Ambulatory Payment Classification
All Patient Diagnostic Related Grouping
Ambulatory Patient Groups (See APC)
Application Programming Interface
Asia Pacific (Visa)
Anti-Phishing Protection
American Physical Therapy Association
Accounts Payable
Accounts Receivable
Standard (sponsored by HL7) formal procedural language that represents medical
algorithms in clinical information systems as knowledge modules
American Recovery and Reinvestment Act of 2009
Ambulatory Surgical Center
American Standard Code For Information Interchange
Administrative Service Organization
American Society for Clinical Pathology
Application Service Provider
Web development tools offered by Microsoft Allows build of dynamic web Sites
Automatic Speech Recognition
American Society for Testing and Materials
Authorized Scanning Vendor
Asynchronous Transfer Mode
Ability To Pay
Acceptable User Policy
See Pre-cert
Address Verification
Address Verification Services
Average Wholesale Price
Annual Wellness Visit
Business to Business
Business to Consumer
Business Associate
Business Associate Agreement
Billing Accounts Receivable
Balanced Budget Act of 1997
Byzantine Banking Gobbledygook (S. Bagwell)
Balanced Budget Refinement Act of 1999
Blue Cross Blue Shield
Business Continuity Planning
Billing Interface
Business Intelligence
Business Impact Analysis
Bank Identification Number
Basic Input/Output System
Benefits Improvement and Protection Act of 2000
Bankruptcy Navigator Index (EFX Add-on Product to Credit Report)
Back Office Conversion
BatchSource (Passport Product Abbreviation)
Insurance Company that administers Medicare Part B

PASSPORT GLOSSARY September 2011

CAGR
CAH
CAHPS
CAM
CAQH
CARC
CAS
CAS
CASS
CAT
CAT
CAT
CAV
CBO
CBO
CBSA
CCAP
CC
CCD
CCD
CCHIT
CCI
CCN
CCO
CCOW
CCP
CCR
CDHP
CDI
CDM
CDONTS
CDS
CDSS
CDT
CE
CED
CERT
CFC
CFR
CFTC
CGI
CHAMPUS
CHAMPVA
CHIE
CHIM
CHIME
CHIN
CHIPRA
CHO
CHPL
CHR
CIA
CICA
CICA

Compound Annual Growth Rate

Critical Access Hospital
Consumer Assessment of Healthcare Providers and Systems
Consumer Account Mangement
Council for Affordable Quality Healthcare
Claim Adjustment Reason Code
Compliance Analyzer Service
Code Access Security
Coding Accuracy Support System (U.S. Postal Service Certification)
Computed Axial Tomography (see CT)
Client Admin Tool
Cardholder Activated Transaction (Visa)
Card Authentication Value (JCB Card)
Central Billing Office
Congressional Budget Office
Core Based Statistical Area
Compliance Checker All Payer (Changed to ISMN)
Complication & Co Morbidity
Continuity of Care Document
Corporate Credit or Debit
Certification Commission for Healthcare Information Technology
Correct Coding Initiative
Care Core National (Radiology Benefits Management Company)
Chief Compliance Officer
Clinical Content Objective Workgroup (One of the HL7 Standards)
Credit Card Processor
Continuity of Care Record
Consumer Directed Health Plan
Clinical Documentation Improvement
Charge Description Master
Collaboration Data Objects for Windows NT Server
Clinical Decision Support
Clinical Decision Support System
Current Dental Terminology
Covered Entity
Coverage With Evidence Development
Comprehensive Error Rate Testing
Conditions For Coverage
Code of Federal Regulations (Federal Register)
Commodity Futures Trading Commission
Common Gateway Interface
Civilian Health and Medical Program, Uniformed Service (Now TriCare)
Civilian Health and Medical Program, Veteran Affairs (Not Same As TriCare)
Clinical Health Information Exchange
Center For Healthcare Information Management
College of Healthcare Information Management Executives
Community Health Information Network
Childrens Health Insurance Program Reauthorization Act 2009
Comprehensive Health Organization
Certified Health IT Product List (ONC)
Community Health Records
Corporate Integrity Agreement
Context Inspired Component Architecture (ASC X12's syntax neutral architecture)
Competition in Contracting Act

PASSPORT GLOSSARY September 2011

CICS
CIE
CIFS
CIM
CIO
CIRT
CIS
CIS
CISP
CLFS
CLIA
CLMA
CM
CMIO
CMN
CMOS
CMP
CMP
CMPL
CMS
CMVP
CNA
CNIO
CNO
CNM
CNS
COA
COA
COB
COBRA
COC
COI
COLA
COLD
CORE
CPC
CPC-H
CPC-P
CPG
CPI
CPOE
CPR
CPSI
CPT-4
CPU
CQI
CR
CRA
CRC
CRCR
CRM
CRON
CROWN
CRT

Customer Information Control System

Customer Initiated Entry
Common Internet File System
Medicare Coverage Issues Manual
Chief Information Officer
Computer Incident Response Team
Center For Internet Security
Clinical Information System
Cardholder Information Security Program
Clinical Laboratory Fee Schedule
Clinical Laboratory Improvement Amendment
Clinical Laboratory Management Association
Case Manager
Chief Medical Information Officer
Certificate of Medical Necessity
Complementary MetalOxideSemiconductor
Competitive Medical Plans
Civil Monetary Penalties
Civil Monetary Penalties Law
Centers for Medicare and Medicaid Services
Cryptographic Module Validation Program
Certified Nursing Assistant
Chief Nursing Information Officer
Chief Nursing Officer
Certified Nurse Midwife
Clinical Navigation System
Change of Address
Certificate Of Authentication
Coordination of Benefits
The Consolidated Omnibus Budget Reconciliation Act of 1985
Certificate of Coverage
Complexity of Illness
Cost of Living Allowance
Computer Output to Laser Disk
Committee on Operating Rules For Information Exchange
Certified Professional Coder (American Academy Professional Coders)
Certified Professional Coder Hospital
Certified Professional Coder Payer
Compliance Program Guidance
Consumer Price Index
Computerized Physician Order Entry (Usually IP Pharmacy Orders)
Computerized Patient Record
Computer Programs and Systems, Inc
Current Procedural Terminology- 4th Edition
Central Processing Unit
Continuous Quality Improvement
Change Request (ID Number Assigned to a CMS Transmittal)
Credit Reporting Agency
Clinical Research Coordinator
Credentialed Revenue Cycle Representative
Customer Relationship Management
Time-based job scheduler in Unix-like computer operating systems
Consolidated Renal Operations in Web-Enabled Network
Cost Revenue Table (See CDM)

PASSPORT GLOSSARY September 2011

CSC
CSE
CSPC
CSV
CTE
CTO
CTR
CT
CTX
CVC
CVV
CY
DAB
DBA
DBMS
DCF
DDA
DDE
CDHP
DEA
DEFRA
DES
DFI
DHCP
DHHS
DHTML
DICOM
DISA
DLL
DLP
DLPVID
DME
DMEPOS
DMERC
DNE
DNFB
DNS
DOB
DOEBA
DOJ
DOL
DOLBA
DPAHC
DPNA
DRA
DRG
DRP
DRS
DSA
DSH
DSL
DSL
DSLOB
DSMT

Card Security Code (AMEX)

Communications Security Establishment (Canadian Government)
Claims Status Productivity Center
Comma Separated Value
Clinical Transaction Engine (Healthworks Acronym)
Chief Technology Officer
Click Through Rate
Computed Axial Tomography (see CAT)
Corporate Trade Exchange
Card Validation Code (MasterCard)
Card Verification Value (Visa Discover)
Calendar Year
Department of Appeals Board (Related to Medicare Appeals)
Data Base Analyst
Database Management System
Discounted Cash Flow
Demand Deposit Account
Direct Data Entry
Consumer Directed Health Plan
Data Encryption Algorithm or Drug Enforcement Administration
Deficit Reduction Act of 1984
Data Encryption Standard
Depository Financial Institution
Dynamic Host Configuration Protocol
Department of Health and Human Services
Dynamic Hypertext Markup Language
Digital Imaging & Communication in Medicine
Data Interchange Standards Association
Dynamic Link-Library
Data Loss Prevention
Data Source Line of Business Pathway Version ID Number
Durable Medical Equipment
Durable Medical Equipment Prosthetics, Orthotics & Supplies
Durable Medical Equipment Regional Carrier (DME Claims Processing)
Death Notification Entry
Discharged Not Final Billed
Domain Name System/Server
Date of Birth
Date of Earliest Billing Activity
Department of Justice
Department of Labor
Date of Latest Billing Activity
Durable Power of Attorney Healthcare
Denial of Payment for New Admissions
Deficit Reduction Act of 2005
Diagnostic Related Grouping
Disaster Recovery Plan
Document Recognition System
Digital Signature Algorithm
Disproportionate Share Hospital
Digital Subscriber Line
Domain Specific Language
Data Source Line of Business
Diabetes Self-Management Training

PASSPORT GLOSSARY September 2011

DSS
DSS
DSTU
DTC
DTP
DURSA
DWF
Dx
EAI
eBXML
EBITDA
EBM
EBP
EBT
eCareNEXT
ECC
ECI
ECF
ECOA
EDB
EDC
EDC
EDC
ED
EDI
EFI
EFS
EFSnet
EFT
EFX
EGHP
EHNAC
EHN
EHR
EIN
EIRF
ELIGIBILITY

E&M
EMC
eMEVS
EMPI
EMR
EMS
EMTALA
ENT
ENTSSO
EOB
EOB
EOMB
EOP
EPA

Data Security Standard

Decision Support System
Draft Standard For Trial Use
Direct to Consumer
Direct to Partner
Data Use and Reciprocal Support Agreement
Design Web Format
Shorthand for Diagnosis
Enterprise Application Integration
Electronic Business XML (A suite of specifications for conducting business over the
Internet)
Earnings Before Interest, Taxes, Depreciation & Amortization
Employee Benefits Manager
Evidence Based Practice
Electronic Benefit Transfer
Passport Integrated Product Suite (See Web Site)
Elliptic Curve Cryptography
Employment Cost Index
Extended Care Facility
Equal Credit Opportunity Act
Environmental Data Base
Enterprise Data Center
Expected Date of Confinement
Estimated Date of Completion
Emergency Department
Electronic Data Interchange
Electronic File Interchange
Encrypting File System
Concord/First Data Web Payment Services
Electronic Funds Transfer
EQUIFAX
Employer Group Health Plan
Electronic Healthcare Network Accreditation Commission
Electronic Healthcare Network
Electronic Health Record
Employer Identification Number
Electronic Interchange Reimbursement Fee (Charged by Visa/MC)
Insurance policy terms that define who is eligible to get coverage and the
requirements for receiving coverage. These may include length of employment with
the plan sponsor, job status and other provisions
Evaluation and Management Coding System
Electronic Media Claims
Electronic Medicaid Eligibility System
Enterprise Master Patient Index
Electronic Medical Record
Emergency Medical Services
Emergency Treatment & Active Labor Act
Enteral Nutrition Therapy
Enterprise Single Sign-on
Explanation of Benefits
Environmental Data Base
Explanation of Medical Benefits
Explanation of Payments
Exclusive Provider Organization

PASSPORT GLOSSARY September 2011

EPOS
EPR
EPS
EPSDT
EQRO
ER
ERA
ERC
ERISA
eRx
esMD
ESP
ESRD
eTAR
EUI
EU
EV
FACA
FACT
FAR
`
FAST
FBA
FBI
FCA
FCC
FCRA
FDA
FDC
FDMS
FECA
FEC
FEHP
FERPA
FFIEC
FFP
FFR
FFS
FI
FICO
FIFO
FIPS
FIS
FISMA
FISS
FLI
FOIA
FOSS
FPL
FQHC
FRB
FSA
FSAP
FSO
FSRRA

Electronic Point of Sale

Electronic Patient Record (Alternative to EMR)
Earnings Per Share
Early and Periodic Screening, Diagnosis and Treatment
External Quality Review Organization
Emergency Room
Electronic Remittance Advice (835)
Ethics Resource Center
Employee Retirement Income Security Act
E-Prescribing
Electronic Submission of Medical Documentation (CMS RAC Program)
Encapsulated Security Standard
End Stage Renal Disease
Electronic Treatment Authorization Request (Medi-Cal)
End User Investigation
European Union
Eligibility Verification
Federal Advisory Committee Act
Fair and Accurate Credit Transactions Act of 2003
Federal Acquisition Regulation
eCare Financial Analysis Summery Tool
Forms Based Authentication
Federal Bureau of Investigation
False Claims Act
Federal Communications Commission
Fair Credit Reporting Act
Food and Drug Administration
Federal District Court
First Data Merchant Services
Federal Employees Compensation Act
Front End Collections
Federal Employee Health Plan
Family Educational Rights & Privacy Act of 1974
Federal Financial Institutions Examination Council
Federal Financial Participation
Federal Funds Rate
Fee For Service
Fiscal Intermediary (insurance company that administers Medicare Part A)
Fair Isaac and Company (Credit Scoring Model)
First In First Out (Inventory Method)
Federal Information Processing Standard
Fidelity National Information Services (Formerly Link2Gov)
The Federal Information Security Act of 2003
Fiscal Intermediary Standard System
Fraud Level Indicator
Freedom of Information Act
Free and Open Source/Solutions Software
Federal Poverty Level
Federally Qualified Health Center
Federal Reserve Board
Flexible Spending Account
Financial Services Accreditation Program
Financial Service Organization
Financial Services Regulatory Relief Act of 2006

PASSPORT GLOSSARY September 2011

FSS
FTC
FTE
FTP
FUL
FUS
Fx
FY
GAAP
GAF
GAO
GAR
GCP
GDP
GEM
GIF
GIPSE
GLBA
GME
GPO
GSA
GSM
GUI
HAC
HAI
HBA
HBOT
HCBS
HCC
HCCA
HCFA
HCFA 1450
HCFA 1500
HCFAC
HCPCS
HCPP
HCRIS
HDHP
HEAT
HDI
HEDIS
HETS
HFMA
HHA
HHABN
HHS
HI
HIAA
HIC
HICN
HIDS
HIE
HIEAP
HIE-SP

Florida Shared System

Federal Trade Commission
Full Time Equivalent
File Transfer Protocol
Federal Upper Limit
Follow Up System
Shorthand for Fracture
Fiscal Year
Generally Accepted Accounting Principles
Geographic Adjustment Factor
General Accounting Office
General Audit Requirements
Good Clinical Practice
Gross Domestic Product
General Equivalence Mapping (Typically in reference to ICD-10)
Graphic Interchange Format
Geo Coded Interoperable Population Summary Exchange
The Gramm-Leach-Bliley Act
Graduate Medical Education
Group Purchasing Organization
General Services Administration
Global System for Mobile Communication
Graphical User Interface
Hospital Acquired Condition
Hospital Acquired Infection
Health & Beauty Aids
Hyperbaric Oxygen Therapy
Home and Community Based Services
Hierarchical Coexisting Condition
Health Care Compliance Association
Health Care Financing Administration (Now Known As CMS)
Universal form used to bill Part A hospital based service to FI (UB-92)
Universal Form for billing professional services to Part B Carrier (CMS-1500)
Health Care Fraud and Abuse Control Program
Healthcare Common Procedural Coding System
Healthcare Pre-Payment Plan
Hospital Cost Report Information System
High Deductible Health Plan
Health Care Fraud Prevention & Enforcement Action Team
Health Data Intermediary
Health Employer Data & Information Set
HIPAA Eligibility Transaction System
Healthcare Financial Management Association
Home Health Agency
Home Health ABN
Department of Health and Human Services
Hospital Insurance Trust Fund
Health Insurance Association of America
Health Insurance Card or Health Insurance Claim Number (HIC number)
Health Insurance Card or Health Insurance Claim Number
Host based Intrusion Detection System
Health Information Exchange
Health Information Exchange Accreditation Program (EHNAC Program)
Health Information Exchange Service Provider

PASSPORT GLOSSARY September 2011

HIH
HIM
HIMSS
HIN
HINN
HINN II
HIO
HIO
HIPAA
HIPTN
HIQA
HIQH
HISB
HIS
HIS
HIT
HITPC
HITECH
HITRC
HITSC
HL7
HMO
HMS
HNAP
HOPD
HPI
HPIC
HQA
HQI
H.R.1
HR4157
HRA
HRA
HRSA
HSA
HSRV
HTML
HTTP
HTTPS
Hx
IAT
IBBM
IBNR
ICA
ICD-9
ICD-10
ICD-10 CM
ICD-10 PCS
ICE
ICF
ICH
ICN
ICR

Health Information Handler (Clearing House Claims Processor)

Health Information Management (Medical Records Management)
Healthcare Information Management Society
Healthcare Identification Number
Hospital Issued Notice of Non-Coverage
New HINN for use with diagnostics etc not bundled to Inpatient Care
Health Insuring Organization
Health Information Organization
Health Insurance Portability and Accountability Act of 1996
Health Information Partnership for Tennessee
Health Insurance Query Access (DDE Eligibility)
Health Insurance Query- Home (Home Health DDE Eligibility)
Health Informatics Standards Board
Hospital Information System
Health Information Services
Health Information Technology
Health Information Technology Policy Committee
Healthcare Information Technology Economic & Clinical Health Act
Health Information Technology Research Center
Health IT Standards Committee
Health Level 7 Interface requirements for healthcare organization
Health Maintenance Organization
HealthCare Management Systems (A/R Billing Management System)
Healthcare Network Accreditation Program (EHNAC Program)
Hospital Outpatient Department
History of Present Illness
Healthcare Personal Identification Card
Hospital Quality Assurance
Hospital Quality Initiative
American Recover & Reinvestment Bill of 2009 (Stimulus Package)
Health Information Technology Promotion Act of 2006
Health Reimbursement Arrangement
Health Risk Assessment
Health Resources and Services Administration
Health Savings Account
Hospital Specific Relative Value
Hypertext Markup Language
Hypertext Transfer Protocol
Hypertext Transfer Protocol Secure
Shorthand for History
Import Address Table
Internet-Based Business Model
Incurred But Not Reported
Internet Check Acceptance Interface
International Classification Disease 9th Edition (Diagnosis Coding System Current)
International Classification Disease 10th Edition (Diagnosis Coding System
Proposed)
International Classification Disease 10th Edition Clinical Modification
International Classification Disease 10th Edition Procedure Classification System
Integrated Community EHR
Intermediate Care Facility
International Conference on Harmonization
Internal Control Number
Intelligent Character Recognition

10

PASSPORT GLOSSARY September 2011

IDN
IDTF
IDS/IPS
ID Report
IEQ
IFR
IFRS
IG
IHDN
IHE
IHI
IHN
IHP
IHS
IHS
IIHI
IIS
ILM
IntelliAV
IOM
IPA
IPAM
IP
IPF
IPIA
IPM
IPPS
IPS
IRF
ISDN
ISMN
ISN
ISO
ISO
IS
IS
ISO 8583
IPCARE
ISP
IVR
JAVA
JCAHO
J-Code
JHITA
JPEG
KBA
KPI
KYC
L2C
LAC
Link2Gov
LMRP

Integrated Delivery Network

Independent Diagnostic Testing Facility
Intrusion Detection System/Intrusion Protection System
Demographic Portion of the EFX Credit Report
Initial Enrollment Questionnaire
Interim Final Rule
International Financial Reporting Standard
Inspector General
Integrated Healthcare Delivery Network
Integrating Healthcare Enterprise
Institute For Healthcare Improvement
Integrated Healthcare Network
Indemnity Health Plan
Indian Health Service
Integrated Health System
Individually Identifiable Health Information
Internet Information Server Microsoft Application
Information Lifecycle Management
Passport AV Product Abbreviation (See Website)
Institute of Medicine
Independent Practice Association / Independent Physicians Association
Internet Protocol Address Management
Inpatient
Inpatient Psychiatric Facility
Improper Payment Information Act
IntelliSource Patient Management
Inpatient Prospective Payment System (Acute Care Hospital)
In Process Scripting
Inpatient Rehabilitation Facility
Integrated Services Digital Network
IntelliSource Medical Necessity (now OrderChecker)
Integrated Services Network
International Standards Organization Networks of National Standards Institute of
146 Countries
Independent Sales Organization (FDMS)
Information Systems or Information Services
IntelliSource (Passport Product Abbreviation)
Established Communication Standard Between Financial Systems
Service provided after a patient is admitted to the hospital. Inpatient care lasts 24
hours or more
Internet Services Provider
Interactive Voice Response or Responder
Object oriented, platform independent, programming language
Joint Commission on Accreditation of Healthcare Organizations
A subset of HCPCS Level II (Used to identify certain Drugs)
Joint Healthcare Information Technology Alliance
Joint Photographic Experts Group
Knowledgebase Assessment
Key Performance Indicator
Know Your Customer
Passport AV Partner
Latin America & Caribbean (Visa)
Passport Legacy Credit Card Partner Gateway (Renamed FIS 1/2010)
Local Medical Review Policy (Obsolete 12/2005)

11

PASSPORT GLOSSARY September 2011

LCD
LEIE
LGHP
LIFO
LINQ
LIS
LOB
LOI
LOINC
LOOP
LOS
LTC
LTCF
MA
MAC
MAC
MAC
MAP
MAPI
MCARE
MCC
MCM
MCO
MCPI
MCR
MCS
MDC
MDDS
MDH
MDS
MEDITECH
MedPac
MEI
MEVS
MFCU
MGMA
MIB
MID
MIG
MIP
MIPPA
MITA
MITA
MITS
MLN
MLP
MLR
MLT
MMA
MMEA
MMIS
MM
MMSEA

Local Coverage Determination (Formerly Known As LMRP)

List of Excluded Individuals and Entities
Large Group Health Plan
Last In First Out (Inventory)
Language Integrated Query
Laboratory Information System
Line of Business
Level of Injury
Logical Observation Identifier Names and Codes
A repeating Structure or Process
Length of Stay
Long Term Care
Long Term Care Facility
Medicare Advantage
Medicare Appeals Council
Medicare Administrative Contractor (Future replacement for Medicare FI/Carrier
System)
Message Authentication Code
Measure Apply Perform
Messaging Application Programming Interface
Medicare Customer Assistance Regarding Eligibility
Major Complication & Co Morbidity
Medical Case Management
Managed Care Organization
Medical Consumer Price Index
Medical Cost Report
Medical Credit Score
Major Diagnostic Categories
Medical Device Data Systems
Medicare Dependent Hospital
Minimum Data Set
Medical Information Technology, INC. (MA based Software and Service Company)
Medicare Payment Advisory Commission
Medicare Economic Index
Medicaid Eligibility Verification System
Medicaid Fraud Control Unit
Medical Group Management Association
Management Information Base
Merchant Identification Number
Medicare Insured Group
Medicare Integrity Program
The Medicare Improvements for Patients and Providers Act of 2008
Medicaid Information Technology Alliance
Medical Imaging & Technology Alliance
Medicaid Information Technology System
Medicare Learning Network
Mid Level Practitioner (RNP PA)
Medical Loss Ratio
Medical Laboratory Technician
Medicare Modernization Act of 2003
Medicare & Medicaid Extender Act 2010
Medicaid Management Information System
Medical Management (Utilization Review Case Management)
Medicare Medicaid & SCHIP Extension Act of 2007

12

PASSPORT GLOSSARY September 2011

MOE
MPEG
MPI
MPN
MPPR
MR
MRI
MSA
MSA
MS-DRG
MSP
M+C
M+CO
MORCASH
MSA
MS-DRG
MSO
MSP
MT
MTE
MTF
MUD
MUD
MUE
Mx
NAAC
NACHA
NAHAM
NAHDO
NAHIT
NAIC
NAICS
NARB
NARC
NARV
NAS
NAT
NBL
NCA
NCD
NCH
NCHS
NCI
NCOA
NCPDP
NCQA
NCUIC
NCVHS
NDA
NDC
NEC
NEHN
NEIC
NEMB

Maintenance of Effort (Medicaid CHIP Rules)

Moving Picture Experts Group
Master Patient (or Person) Index
Medicare Provider Number
Multiple Procedure Payment Reduction
Medical Review
Magnetic Resonance Imaging
Medicare Statistical Area or Medical Savings Account
Multi-State Area
Medicare Severity Diagnostic Related Grouping
Medicare Secondary Payer
Medicare + Choice
Medicare + Choice Organization
Medicare Outpatient Revenue Collection Assessment Service - Hospital
Medical Savings Account
Medicare Severity DRGs
Management Services Organization
Medicare Secondary Payer
Medical Technologist
Machine Transfer Entry
Medical Treatment Facility
Medically Unnecessary Days
Master User Database
Medically Unlikely Edits
Shorthand for Metastasis
Net Average Allowable Cost (EHR Technology)
National Automated Clearing House Association
National Association of Healthcare Access Management
National Association of Health Data Organizations
The National Alliance For Health Information Technology
National Association of Insurance Commissioners
North American Industry Classification System
Name & Address Resource Business Database
Name & Address Resource Consumer Database
Name & Address Resource Vehicle Database
Network Attached Storage
Network Address Translation/Transaction
National Business Lists
National Credentialing Association
National Coverage Determination
National Claims History System
National Center For Health Statistics
National Cancer Institute
National Change Of Address
National Council of Prescription Drug Programs
National Committee for Quality Assurance
National Council For Uniform Interest Compensation
National Committee on Vital and Health Statistics
Non Disclosure Agreement
National Drug Code
Not Elsewhere Classified
New England Healthcare Exchange Network, Inc.
National Electronic Information Corporation
Notice of Exclusion of Medicare Benefit (Retired 3/2010)

13

PASSPORT GLOSSARY September 2011

.NET
NERC
NFS
NHE
NHIN
NHS
NIA
NIC
NIH
NIST
NLR
NMR
NOA
NOC
NOI
NOPR
NOS
NPI
NPP
NPRM
NPSG
NQF
NRSRO
NSA
NSF
NTIS
NUBC
NUCC
NVHRI
OAA
OAS
OASIS
OB
OBC
OBRA
OBS
OCE
OCR
OCR
ODF
ODFI
ODJFS
OESS
OGC
OHP
OID
OIG
OMB
OmniLinkSM
ONC
ONCHIT
OON
OOP
OOP

Microsoft strategy for connecting systems, information & devices via web services
North American Electric Reliability Corporation
Network File System
National Health Expenditure
Nationwide Health Information Network
National Health Service
National Imaging Associates (Radiology Benefits Management Company)
Network Interface Card
National Institutes of Health
National Institute of Standards and Technology
National Level Repository
Nuclear-Magnetic Resonance
Notice of Admission
Notice of Change
Notice of Intent
National Oncologic PET Registry
Not Otherwise Specified
National Provider I.D. (Replaced UPIN June 2007)
Non-Physician Practitioner
Notice of Proposed Rule Making
National Patient Safety Goals
National Quality Forum
Nationally Recognized Statistical Ratings Organization
Non Surgical Admission
National Standard Format
National Technical Information Service
National Uniform Billing Committee
National Uniform Claim Committee
National Voluntary Hospital Reporting Initiative
Old Age Assistance Program
Office of Audit Services
Outcome and Assessment Information Set
Obstetrics
Orange Book Code
Omnibus Budget Reconciliation Act
Observation Services
Outpatient Code Editor
Office of Civil Rights
Optical Character Recognition
Open Door Forum
Originating Depository Financial Institution
Ohio Department of Job & Family Services
Office of E-Health Standards & Services (An Office of CMS)
Office of General Counsel
Ohio Health Plan
Object Identifier
Office of the Inspector General
Office of Management Budget
McKesson centralized pharmacy software
Office of the National Coordinator for Health Information Technology
The Office of the National Coordinator for Health Information and Technology
Out of Network
Out of Plan
Object Oriented Programming (VB.Net)

14

PASSPORT GLOSSARY September 2011

OP
OPCARE
OPD
OPPS
OrderRite
ORMIS
OSI
OS
OT
OTS
P4P
PACS
PACT
PAH
PAHP
PAN
PAPB
PAPD
PAT
PAV
Payment Navigator
P/BAR
PBM
PCA
PC
PCI
PCI
PCI DSS
PCIP
PCI SSC
PCOA
PCP
PCPM
PDE
PDP
PEPPER
PET
PERM
PFI
PFOS
PFS
PHB
PHC
PHCP
PHI
PHO
PHR
PHS
PHSA
PIC
PIMS
PIN
PIPEDA

Outpatient
Care provided in a clinic, emergency room, hospital or non-hospital surgical center,
without admitting the patient.
Outpatient Department
Outpatient Prospective Payment System
PHC Product Manages Pre-Certs, Medical Necessity (See Web Site)
Operating Room Management Information System
Open System Interconnection
OneSource (Passport Product Abbreviation)
Occupational Therapy
Office of Thrift Supervision
Pay For Performance
Picture Archiving Communications System (Radiology EHR)
Post Acute Care Transfer Rule
Patient Account History
Pre-Paid Ambulatory Health Plan
Primary Account Number
Payer Application Best Practice
Planning Advice Planning Document
Pre-Admission Testing
Patient Access Verification
PHC Product Financial Screening (See Web Site)
Patient/Billing Accounts Receivable System
Pharmacy Benefits Manager
Pre-Submission Compliance Analyzer
Professional Component (Billing Term)
Pending Client Issues (PHC Enrollment Term)
Payment Card Industry
Payment Card Industry Data Security Standard
Pre-Existing Condition Insurance Plan
Payment Card Industry Security Standards Council
Proprietary Change of Address
Primary Care Physician
Per Contract Per Month
Prescription Drug Event
Prescription Drug Plan
Program For Evaluating Payment Patterns Electronic Report
Positive Emission Tomography
Payment Error Rate Measurement
PCI Forensic Investigator
Patient Financial Obligation Statement
Physician Fee Schedule
Pharmacy Benefits Manager
Passport Health Communications, Inc.
Primary Healthcare Physician or Provider
Protected Health Information
Physician Hospital Organization
Personal Health Record
Public Health Service
Public Health Service Act
Passport IntelliSource Client
Pharmacy Information Management System
Personal Identification Number
Personal Information Protection and Electronic Documents Act

15

PASSPORT GLOSSARY September 2011

PKI
PL
PM
PMH
PMPM
PM/R
PMS
PNG
POA
POC
POF
POP
PPA
PPACA
PPC
PPCE
PPD
PPE
PPI
PPS
PPO
PPR
PPS
PQRI
PRA
PRE-CERT
PRG
PRM
PRO
PRS
POC
POS
PSH
PSN
PSO
PTAN
PTD
PTO
PT
PVV
PWK
Px
QHR
QIC
QIO
QOS
QRDA
QSA
RA
RAC
RAID
RAND
RARC

Public Key Infrastructure

Patient Locator
Program Memorandum
Patient Medical History
Per Member Per Month
Physical Medicine/Rehabilitation (PT OT & Speech Therapy)
Practice Management System (Physicians Office Environment)
Portable Network Graphics
Present on Admission
Plan of Care or Point of Care Proof of Coverage
Proof Of Funds
Point of Purchase
Preferred Provider Arrangement
Patient Protection and Affordable Care Act
Provider-Preventable Condition
Provider Payment Cost Estimation
Prearranged Payment & Deposit
PHC Product - Patient Payment Estimator (See Web Site)
Provider Price Index
Prospective Payment System
Preferred Provider Organization
Paper Based Patient Record
Prospective Payment System
Physician Quality Reporting Initiative
Paperwork Reduction Act
The process of receiving approval for some health care, such as hospitalization,
outpatient surgery or prescription drugs, before it can be covered.
Procedure Related Group
Provider Reimbursement Manual
Peer Review Organization
Practice Related Risk Score
Point of Care
Point (or Place) of Service or Point of Sale
Patient Surgical History
Provider Sponsored Networks
Provider Service Organization
Provider Transaction Access Number
Payer Transaction Density
Paid Time Off
Physical Therapy
PIN Verification Value
Paperwork Segment X12N Version 5010
Shorthand for Procedure
Quorum Health Resources
Qualified Independent Contractor (Related to Medicare Appeals)
Quality Improvement Organization
Quality of Service
Quality Reporting Document Architecture
Qualified Security Assessor
Remittance Advice (ERA 835)
Recovery Audit Contractor
Redundant Array of Independent Disks
Research and Development Corporation
Remittance Advice Remark Code

16

PASSPORT GLOSSARY September 2011

RBM
RBRVS
RCK
RCM
RCS
RDFI
RDP
RDRG
REC
REFERRAL

RHC
RHIO
RHIT
RIA
RIAA
RLS
RRAS
RN
ROA
ROC
ROE
ROI
RPO
RQA
RRA
RRT
RTE
RTO
RUG
RULE
RVS
RVU
Rx
RY
SA
SAAS
SAF
SAN
SAQ
SAS70
SB
SBA
SCH
SCHIP
SCSI
SDC
SDEs
SDO
SEC
SEC
SEO
SFR

Radiology Benefits Manager

Resource-Based Relative Value Scale
Re-Presented Check
Revenue Cycle Management
Revenue Cycle Solutions
Receiving Depository Financial Institution
Remote Desktop Protocol Terminal Services
Refined Diagnostic Related Grouping
Regional Extension Center (Health Information Technology)
Specific directions or instructions from a member's PCP that directs a member to a
participating health care professional for medically necessary care. A referral may be
written or electronic
Rural Health Clinic
Regional Health Information Organization
Registered Health Information Technician
Regulatory Impact Analysis
Recording Industry Association of America
Record Locator Service
Request and Response Aggregation Support
Registered Nurse
Return on Assets
Report on Compliance
Return on Equity
Return on Investment
Recovery Point Objective
PHC Product - Registration Quality Assurance (See Web Site)
Registered Records Administrator
Registered Respiratory Therapist
Response Transaction Embellishment
Recovery Time Objective
Resource Utilization Groups
Review Utilization Line Edit (Medicare Processing)
Relative Value Scale
Relative Value Unit
Shorthand for Prescription
Rate Year
Search America
Software As A Service (SaaS)
Standard Analytical File
Storage Area Network
Self Assessment Questionnaire
Statement on Auditing Standard 70
Separately Billable
Small Business Administration
Sole Community Hospital
State Childrens Health Insurance Program (Reference Medicaid)
Small Computer System Interface
Surgical Day Care
State Designated Entities
Small Dialysis Organization
Securities & Exchange Commission
Standard Entry Class Codes
Search Engine optimization
Sliding Fee Review

17

PASSPORT GLOSSARY September 2011

SFY
SGR
SHA
SIC
SIEM
SLA
SMHP
SMI
SMP
SMS
SNF
SNIP
SNMP
SNOMED
SOAP
SOAP
SOC
SOM
SOW
SOX
SP
SPSP
SPD
SPML
SPR
SRE
SSA
SSA DMF
SSEL
SSI
SSID
SSIS
SSMS
SSN
SSO
SSO
SSRS
S&S
STC
SQL
SUNQUEST
SURS
SWG
Sx
TA1
TAG
TARP
TC
TCM
TCP/IP
TDES
TFL
TID
TIN

State Fiscal Year

Sustainable Growth Rate
Secure Hash Algorithm
Standard Industrial Classification
Security Incident and Event Management
Service Level Agreement
State Medicaid Health Information Technology Plan
Supplementary Medical Insurance
Senior Medicare Patrol
Shared Medical Systems
Skilled Nursing Facility
Strategic National Implementation Process (A WEDI program)
Simple Network Management Protocol
Systematized Nomenclature of Medicine
Subjective Objective Assessment & Plan (Charting System)
Simple Object Access Protocol
Standard Occupational Classifications
State Operations Manual
Statement of Work
Abbreviation for Sarbanes-Oxley
Self Pay
Society of Payment Security Professionals
Summary Plan Description
Service Provisioning Markup Language
Self Pay Review
Serious Reportable Event
Social Security Administration
Social Security Administration Death Master File
Standard Statistical Establishment List
Supplemental Security Income
Service Set Identifier
SQL Server Integration Services
SQL Server Management Studio
Social Security Number
Standard Setting Organization
Single Sign-on
SQL Server Reporting Services
Store & Serve
Service Type Code
Structured Query Language - Software language used to talk to most databases
Laboratory Information System Brand Name
Surveillance & Utilization Review Subsets Units
Sub Work Group
Shorthand for symptoms
Interchange Acknowledgement
Technical Advisory Group (CMS Department)
Troubled Assets Relief Program
Technical Component (Billing Term)
Targeted Case Management
Transmission Control Protocol/Internet Protocol
Triple Data Encryption Standard (AKA 3DES)
TriCare For Life
Terminal Identification Number
Taxpayer Identification Number

18

PASSPORT GLOSSARY September 2011

TLS
TNF
TNR
TOA
TPA
TPL
TPMS
TPO
TPP
TPR
TPSP
TPTS
TQM
TRHCA
TRN
T-SQL
TTM
Tx
UAA
UAT
UB
UB-92
UB-04
UCAT
UCC
UCF
UCR
UCRN
UCUM
UDRVs
UETA
UHDDS
UHIN
UI
UM
UNII
UOE
UOS
UPC
UPD
UPIN
UPL
URO
UROE
UR
URL
USAO
USB
USC
USHEI
USPS
USRDS
VA
VAN

Transport Layer Security

True Name Fraud
Telephone Number Resource
Threshold Override Authorization
Third Party Administrator (Healthcare Claims Processing Entity)
Third Party Liability
Trading Partner Management System
Treatment Payment & Healthcare Operations
Transaction Processing Platform
Transaction Protocol Redirection
Third Party Service Provider
Trading Partner Tracking System
Total Quality Management
Tax Relief Healthcare Act of 2006
Transaction Acknowledgement
Transact- SQL is central to using SQL Server
Time To Market
Shorthand for Treatment
Undeliverable as Addressed
User Acceptance Testing
Uniform Bill
Universal Billing Form used to bill Part A hospital based service to FI (HCFA 1450)
Universal Billing Form (paper) (replaced UB-92 March 2007)
Unattended Cardholder Activated Transaction (Visa)
Uniform Commercial Code
Uniform Claim Form
Usual Customary and Reasonable fees
Unique Claim Record Number
Unified Code For Unites of Measure
User Definable Response Views
Uniform Electronic Transactions Act
Uniform Hospital Discharge Data Set
Utah Health Information Network
User Interface
Utilization Management (AKA Medical Management)
Unique Integrated Identifier
Universal Order Entry
Units of Service
Universal Product Code
Universal Provider Datasource
Unique Physician Identification Number (Discontinued by CMS June 29,2007)
Upper payment limit
Utilization Review Organization
Universal Remote Order Entry
Utilization Review (Case Management / Medical Management)
Uniform Resource Locator
United States Attorneys Office
Universal Serial Bus
United States Code
The United States Healthcare Efficiency Index
United States Postal Service
United States Renal Data System
Veterans Administration
Value Added Network

19

PASSPORT GLOSSARY September 2011

VAR
VB.NET
VBP
VEBA
VFCRA
VHA
VHA
VIPS
VMAP
VOL
VPN
VPS
WAC
WAMP
WEDI
WEP
WFM
WG
WHO
WIC
WIR
WPC
WPI
XACTION
XML
XSL
X12
X12 270
X12 271
X12 276
X12 277
X12 277CA
X12 278
X12 834
X12 835
X12 837
X12 837i
X12 837p
X12 997
X12 999
X12 TA1
XSS
YPDA
YPDD
YTD
ZCTA
ZPP

Value Added Reseller

Visual Basic.NET Object-oriented programming
Value Based Purchasing
Volunteer Employee Benefits Association
Vermont Fair Credit Reporting Act
Veterans Hospital Administration
Volunteer Hospital Association
Viable Information Processing System
ViPS Medicare Automated Parameter
Visa On-Line
Virtual Private Network
Volume Performance Standard System
Wholesale Acquisition Cost
Widely Available Market Price
Workshop for Electronic Data Interchange
Wired Equivalent Privacy
Workflow Management
Workgroup
World Health Organization
Womens Infants & Children (Special Supplemental Nutrition Program)
Week In Review
Washington Publishing Company
WiFi Protected Access
Transaction
Extensible Markup Language-Standards for HL7s entire platform
XML Style sheet Language
An ANSI-accredited group that defines EDI standards for many American industries,
including healthcare insurance
The X12 HealthCare Eligibility & Benefit Inquiry transaction
The X12 Health Care Eligibility & Benefit Response transaction
X12 Healthcare Claims Status Inquiry
X12 Claims Status Response
Claim Acknowledgement Transaction
Referral, pre-certification or authorization inquiry or submit
X12 Enrollment & Maintenance Transaction
X12Healthcare Claim Payment and Remittance Advice Transaction
X12 Healthcare Claim or Encounter Transaction
See X12 837 Institutional Version
See X12 837 Professional Version
Functional Acknowledgement for 837 Claims
Acknowledgement transaction using Technical Report type 3
Technical Acknowledgment
Cross Site Scripting
Yellow Pages Directory Assistance
Yellow Pages Data Delivery
Year To Date
Zip Code Tabulation Area
Medicare HMO Zero Premium Plans

20