Abbreviations and acronyms
Select the number or first letter of the abbreviation or acronym that you're looking for:
2
| 2/2 | Secondary To |
3
| 3 R's | Risk Adjustment, Reinsurance, Risk Corridors |
4
| 4WW | Four Wheeled Walker |
A
| ABA | Applied Behavioral Analysis (related to autism mandate) |
| AC | Alternative Care |
| ACA | Affordable Care Act |
| ACES | Adjudication and Claims Entry System |
| ACG | Adjusted Clinical Groups (John Hopkins) |
| ACH | Average call handled |
| Automatic Clearing House | |
| ACO | Accountable Care Organization |
| AD | Assistive Device |
| ADA | American Dental Association |
| Americans with Disabilities Act | |
| AD&D | Accidental Death & Dismemberment |
| ADEA | Age Discrimination in Employment Act |
| AGI | Adjusted Gross Income |
| AHIP | America's Health Insurance Plans |
| AHP | Association Health Plan Groups |
| AICK | Advance Insurance Company of Kansas |
| ALE | Applicable Large Employer |
| AMA | American Medical Association |
| AMGH | Air Medical Group Holdings |
| AMT | Alternative Minimum Tax |
| APO | Automatic Payment Option |
| APRN | Advanced Practice Registered Nurse |
| APTC | Advanced Premium Tax Credit |
| AQC | Administrative Quality Committee |
| ARC | Administrative Review Committee |
| AROBF | Awaiting Return of Bowel Function |
| ARRA | American Recovery and Reinvestment Act |
| ARUs | Acute Rehab Unit |
| ASC | Ambulatory Surgery Center |
| ASD | Autism Spectrum Disorder |
| ASL | Aggregate Stop Loss |
| ASO | Administrative Services Only |
| Auth | Authorization |
| AV | Actuarial Value |
| AVR | Asset Valuation Reserve |
| AWP | Average Wholesale Price |
B
| B2B | Business to business |
| BAR | Build A Rate (QHP (Qualified Health Plan)) |
| BBKS | BlueCross BlueShield Kansas Solutions |
| BCBSA | Blue Cross Blue Shield Association |
| BCBSKS | Blue Cross and Blue Shield of Kansas |
| BCBSKSF | Blue Cross and Blue Shield of Kansas Foundation |
| BCS | Breast Cancer Screening |
| BDC | Blue Distinction Centers |
| BDE | Benefit Design Enhancement |
| BDTC | Blue Distinction Total Care |
| BE | BluesEnroll |
| BGT | Benefit Generation Table |
| BHI | Blue Health Initiatives |
| Blue Health Intelligence | |
| BlueCard | National program administered by BCBSA that provides Blue Members with access to providers |
| BOHA | Board of Healing Arts |
| BPO | Business Process Outsourcing |
| BPT | Bid Pricing Tool |
| BRD | Business Required Documents |
C
| CAHPS | Consumer Assessment of Healthcare Providers and Systems |
| CAP | Competitive Allowance Program |
| Corrective Action Plan | |
| CAQH | Council for Affordable Quality Healthcare |
| CAUTI | Catheter-Associated Urinary Tract Infections |
| CBF | Capitation Bulk Format |
| CDAD | Chronic Disease Alliance of Kansas |
| CDC | Comprehensive Diabetes Care Measures |
| CCIIO | Center for Consumer Information and Insurance Oversight |
| CCIT | Contract Change Implementation Team |
| CDC | Centers for Disease Control and Prevention |
| Comprehensive Diabetes Care | |
| CDHC | Consumer-Driven Health Care |
| CDHP | Consumer Directed Health Plan |
| CEO | Chief Executive Officer |
| CFO | Chief Financial Officer |
| CHIE | Certified Healthcare Insurance Executive |
| CHS | Catholic Health Systems |
| CID | Civil Investigation Demand |
| CIH | Customer Identity Hub |
| CIO | Chief Information Officer |
| CIWP | Company Imposed Waiting Period |
| CLABS | Central Line Associated Blood Stream Infection |
| CMO | Chief Medical Officer |
| CM | Case Management |
| CMM GF | Comp Major Med Grandfathered |
| CMS | Centers for Medicare and Medicaid Services |
| CMXO | Chief Marketing and Experience Officer |
| CO | Contract Overview |
| COB | Coordination of Benefits |
| COBRA | Consolidated Omnibus Reconciliation Act of 1986 |
| COC | Continuity of Care Document |
| COINS | Coinsurance |
| COO | Chief Operations Officer |
| CPI | Consumer Price Index |
| CQIC | Clinical Quality Improvement Committee |
| CRG | Clinical Risk Groups (Treo (vendor) uses this 3M reporting) |
| CSC | Customer Service Center |
| CSI | Customer Service Inquiry |
| CSR | Cost Sharing Reduction |
| CTD | Charges to Date |
| CVP | Customer Value Partners |
| CX | Customer Experience |
D
| DAC | Dental Advisory Committee |
| DCA | Deferred Compensation Agreement |
| DED | Deductible |
| DIT | Data Integrity Tool |
| DM | Disease Management |
| DME | Durable Medical Equipment |
| DOL | Department of Labor |
| DPOA | Durable Power of Attorney |
| DRG | Diagnosis Related Grouping |
| DTO | Drug Therapy Opportunities |
| DUR | Drug Utilization Review |
E
| E&M | Evaluation and Management |
| EAFE | Europe, Asia and Far East |
| EAPG | Enhanced Ambulatory Patient Groupings |
| EAP | Employee Assistance Program |
| EBP | Episode Based Payments |
| ECA | Executive Clinical Analysis |
| ECHO | Extension for Community Health Care Outcome |
| ECP | Essential Community Provider |
| EDI | Electronic Data Interchange |
| EE | Electronically Enrolled |
| EEO | Equal Employment Opportunity |
| EFT | Electronic Funds Transfer |
| EHB | Essential Health Benefits |
| E/I | Experimental Investigational |
| ELT | Executive Leadership Team |
| Extract, Load, Transform | |
| EOB | Explanation of Benefits |
| EPA | Electronic Provider Access |
| EPIP | Employee Performance Incentive Program |
| EPO | Exclusive Provider Organization |
| ERISA | Employee Retirement Income Security Act of 1974 |
| ESN | Extended Supply Network |
| ESRD | End Stage Renal Disease |
| ERM | Enterprise Risk Management |
F
| FAST | Facilitated Adoption of Sustained Transfer |
| FEIN | Federal Employer Identification Number |
| FEP | Federal Employee Program |
| FFM | Federally Facilitated Marketplace |
| FFS | Fee for Service |
| FI | Fully Insured |
| FLSA | Fair Labor Standards Act |
| FMA | Family Medicine Associates |
| FMLA | Family and Medical Leave Act |
| FOI | Freedom of Information |
| FPL | Federal Poverty Level |
| FQHC | Federally Qualified Health Center |
| FSA | Flexible Spending Account |
| FSMB | Federal State Medical Board |
| FWA | Fraud, Waste & Abuse |
G
| GAC | Group Application Certificate |
| GF | Grandfathered |
| GINA | Genetic Information Nondiscrimination Act |
| GL | Group Leader |
| GSM | Group Setup Maintenance |
| GUR | Group Utilization Report |
H
| HAC | Hospital Advisory Committee |
| HAE | Hereditary Angioedema |
| HB | Homebound |
| HBE | Health Benefit Exchange |
| HCE | Highly Compensation Employee |
| HCTC | Health Coverage Tax Credit |
| HEDIS | Healthcare Effectiveness Data and Information Set |
| HEN | Hospital Engagement Network |
| HDHP | High Deductible Health Plan |
| HHS | Department of Health and Human Services |
| Home Health Service | |
| HIAA | Health Insurance Association of America |
| HICS | Health Insurance Casework System |
| HIM | Health Insurance Marketplace |
| HIOS | Health Insurance Oversight System |
| HIP | Hospital Indemnity Plan |
| HIPAA | Health Insurance Portability and Accountability Act of 1996 |
| HIT | Health Information Technology |
| HITECH | Health Information Technology for Economic and Clinical Health Act |
| HIX | Health Insurance Exchange |
| HMO | Health Maintenance Organization |
| HMS | Health Metric Systems, Inc. |
| HRA | Health Reimbursement Arrangement/Account |
| Health Risk Assessment | |
| HRBC | Health Risk Based Capital |
| HSA | Health Savings Account |
I
| IBNR | Incurred But Not Reported |
| ICD | International Classification of Disease |
| ICN | Inquiry Control Number |
| ID | Identification Card |
| IMR | Interest Maintenance Reserve |
| IN | Inquiry Number |
| IQ | Interqual |
| IRO | Independent Review Organization |
| ISL | Individual Stop Loss |
| ITS | Inter-Plan Teleprocessing Services (network that is used to administer BlueCard) |
| IVF | Intravenous Fluids |
| IVR | Interactive Voice Recording |
J
| JD | Juris Doctorate |
K
| KAFP | Kansas Academy of Family Physicians |
| KAHP | Kansas Association of Health Plans |
| KAMU | Kansas Association of Medically Underserved |
| KCA | Kansas Chiropractic Association |
| KDB | Kansas Dental Board |
| KDHE | Kansas Department of Health & Environment (oversees Kansas Health Insurance Information System and is a government department) |
| KECH | Kansas Employer Coalition on Health Care |
| KEIT | Kansas Educational Insurance Trust |
| KFMC | Kansas Foundation for Medical Care |
| KHA | Kansas Hospital Association |
| KHC | Kansas Healthcare Collaborative |
| KHDS | Kansas Health Data System |
| KHEN | Kansas Hospital Engagement Network |
| KHIE | Kansas Health Information Exchange |
| KHIN | Kansas Health Information Network |
| KHIT | Kansas Health Information Technology Advisory Council |
| KHC | Kansas Health Collaborative |
| KID | Kansas Insurance Department |
| KOMA | Kansas Association of Osteopathic Medicine |
| KSBOHA | Kansas State Board of Healing Arts |
| KSBN | Kansas State Board of Nursing |
| KSBSRB | Kansas Behavioral Sciences Regulatory Board |
L
| LACIE | Lewis and Clark Information Exchange |
| LOB | Line of Business |
| LRBC | Life Risk Based Capital |
| LTC | Long-Term Care |
| LTD | Long-Term Disability |
M
| MA | Medicare Advantage |
| MAC | Medical Advisory Committee |
| Maximum Allowable Cost (at Prime Mail) | |
| MAP | Maximum Allowable Payment |
| MBI | Medicare Beneficiary Identifier |
| MDL | Multi-District Litigation |
| MEC | Minimum Essential Coverage |
| Mess | Message |
| MET | Multiple Employer Trust |
| MEWA | Multiple Employer Welfare Arrangement |
| MFA | Multi-factor Authentication |
| MHP | Mental Health Parity |
| Min A | Minimal Assistance |
| MLR | Medical Loss Ratio |
| MMI | Master Member Index |
| MMR | Measles, Mumps, Rubella Vaccination |
| MN | Medically Necessary |
| MO | Modus Operandi |
| MOC | Maintenance of Certification (Licensing certification of doctors) |
| MOG | Measurement Operations Group |
| MOOP | Maximum Out of Pocket |
| MP | Medical Policy |
| Minimum Premium | |
| MSA | Medical Savings Account |
| Metropolitan Statistical Areas | |
| MSN | Medicare Summary Notice |
| MSP | Medicare Secondary Payer |
| MSPP | Multi-State Plan Program (MSP Program) |
| MSSP | Medicare Shared Savings Program |
| MTM | Member Touchpoint Measures |
| MV | Minimum Value |
N
| NACD | National Association of Corporate Directors |
| NAEO | No Acute Events Overnight |
| NAIC | National Association of Insurance Commissioners |
| NC | Nurse Consultant |
| NCCT | National Consumer Cost Transparency |
| NCPE | National Council of Physician and Pharmacist Executives |
| NCQA | National Committee on Quality Assurance |
| NGF | Non-grandfathered |
| NMN | Not Medically Necessary |
| NMSN | National Medical Child Support Notice |
| NOL | Net Operating Loss |
| NOPP-GLB | Notice of Privacy Practices – Gramm-Leach Bliley |
| NPI | National Provider Identifier |
| NQF | National Quality Foundation |
| NRD | Next Review Date |
| NSD | National Standard Date |
O
| OB | Obstetrics |
| OBRA | Omnibus Budget Reconciliation Act |
| OHCA | Organized Health Care Arrangement |
| OOA | Out of Area |
| OON | Out of Network |
| OOS | Out of State |
| OPPI | Outpatient Practice Process Improvement |
| OPL | Other Party Liability |
| ORSA | Own Risk Solvency Assessment |
| OPM | Office of Personnel Management |
| OSAF | Outpatient Substance Abuse Facilities |
| OTC | Over the Counter |
P
| PA | Plan Administrator |
| PAD | Pre-service, Admission & Discharge |
| PBM | Pharmacy Benefit Management |
| PCMH | Patient Centered Medical Home |
| PBP | Plan Benefit Package |
| PCC | Precert Coordinator |
| PCG | Patient Caregiver |
| PCORI | Patient-Centered Outcome Research Institute |
| PCP | Primary Care Provider |
| PCPCC | Patient-Centered Primary Care Collaborative |
| PCPM | Per Contract Per Month |
| PEO | Professional Employer Organization |
| PHI | Protected Health Information |
| P/I | Pend/Incomplete |
| PII | Personal Identifiable Information |
| PIT | Product Initiative Team |
| P&L 500 Committee | Purchase & Lease 500 Committee |
| PMPM | Per Member Per Month |
| POD | Post-Operative Day |
| POS | Point of Service |
| PPA | Potentially Preventable Admissions |
| PPACA | Patient Protection and Affordable Care Act |
| PPD | Postpartum Delivery |
| PPE's | Potentially Preventable Events |
| PPM | Provider Performance Management |
| PPO | Preferred Provider Organization |
| PPR | Potentially Preventable Readmissions |
| PPV | Potentially Preventable Emergency Room Visits |
| PQM | Physician Quality Measures |
| PrOACT | Problem, Objectives, Alternatives, Consequences and Tradeoffs |
| Prov | Provider |
| PS | Plan Sponsor |
| PSAO's | Pharmacy Service Administration Organization |
| PSO | Provider-Sponsored Organizations |
Q
| QBRP | Quality Based Reimbursement Program |
| QDRO | Qualified Domestic Relations Order |
| QHI | Quality Health Indicators |
| QHP | Qualified Health Plan |
| QIO | Quality Improvement Organization |
| QMCSO | Qualified Medical Child Support Order |
| QMF | Query Management Facility |
| QRS | Quality Rating System |
| QUIP | Quality and Utilization Improvement Process |
R
| R | Right |
| 3 R's | Risk Adjustment, Reinsurance, Risk Corridors |
| RAF | Rate Adjustment Factor |
| RBC | Risk Based Capital |
| RBRVU | Resource Based Relative Value Units |
| RCIN | Rural Clinical Integrated Network |
| Rec'd | Received |
| RFI | Request for Information |
| RFP | Request for Proposal |
| RFR | Request for Reinstatement |
| ROI | Return on Investment |
| RCM | Requirements Confirmation Memo |
| RTC | Residential Treatment Center |
| RVU | Relative Value Unit |
S
| SADP | Stand Alone Dental Program |
| SAR | Summary Annual Report |
| SBAR | Small Business Account Representatives |
| SBAS | Small Business Account Support |
| SBC | Summary of Benefits & Coverage |
| SBC GF | Summary of Benefit Coverage Grandfathered |
| SBM | State-based Marketplace |
| SCOTUS | Supreme Court of the United States |
| SDOH | Social Determinants of Health |
| S-HIP | Secure Hospital Indemnity Program |
| SGIR | Small Group Initial Rating |
| SC | Steering Committee |
| SEHP | State Employees Health Plan |
| SERFF | System for Electronic Rate and Form Filing |
| SERP | Supplemental Executive Retirement Plan |
| SEP | Special Enrollment Period |
| SGRR | Small Group Rate Reform |
| SHOP | Small Business Health Options Program |
| SIU | Special Investigations Unit |
| SME | Subject Matter Expert |
| SMM | Summary of Material Modifications |
| SOA | Strategic Opportunity Analysis |
| Society of Actuaries | |
| SOC 1 | Service Organization Controls Report (relevant to User Entities' Internal Control over Financial Reporting) |
| SOC 2 | Service Organization Controls Report (relevant to Security, Availability, Processing Integrity Confidentiality or Privacy) |
| SOK | State of Kansas |
| SPD | Summary Plan Description |
| SPV | Supervise |
| SQM | Service Quality Measurement Group (Customer Service) |
| SSO | Single Sign On |
| STD | Short-term Disability |
| SU | Set Up |
T
| TAGS | Trait, Age, Gender, Suite (Reporting score used by MDInsight (vendor) |
| TFs | Tube Feeds |
| TIPS | Treasury Inflation Protected Securities |
| TN | Triage Nurse |
| Trop | Troponin |
| TOS | Type of Service |
| TPA | Third Party Administrator |
| Tsfr | Transfer |
U
| UAT | User Access Test |
| UCL | Unpaid Claims Liability |
| UCR | Usual Customary and Reasonable |
| Unpaid Claims Reserve | |
| UM | Utilization Management |
| UPD | Universal Provider Data Source |
| USERRA | Uniformed Services Employment and Re-employment Rights Act |
V
| VBID | Value-Based Insurance Design |
| VBP | Value-Based Program |
| VBR | Value-Based Reimbursement |
| VEBA | Voluntary Employees' Beneficiary Association |
| VIS | Value Index Score |
| VM | Voicemail |
W
| w/c | Which |
| WHCRA | Women's Health and Cancer Rights Act |