A acronyms |
A acronym definitions |
---|---|
A&G |
Administrative and general |
ADR |
Automated desk review |
AHA |
American Hospital Association |
AHSEA |
Adjusted hourly salary equivalency amount |
AICPA |
American Institute of Certified Public Accountants |
ALJ |
Administrative law judge |
ALOS |
Average length of stay |
APC |
Ambulatory payment classification |
AQCC |
Audit Quality and Consistency Committee |
ASC |
Appeals Support Contractor (Contract with BSBSA) |
ASC |
Ambulatory surgical center |
ASP |
Average sales price |
ASWS |
Approved Standard Workpaper Subcommittee |
B | |
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BBA |
Balanced Budget Act of 1997 |
BBRA |
Balanced Budget Refinement Act of 1999 |
BCBSA |
Blue Cross Blue Shield Association |
BIPA |
Benefits Improvement and Protection Act of 2000 |
BLS |
Bureau of Labor Statistics |
C acronyms |
C acronym definitions |
---|---|
CAF |
Continuing audit file (also called Permanent File) |
CAH |
Critical access hospital |
CAP |
Corrective action plan |
CAPD |
Continuous ambulatory peritoneal dialysis |
CBSA |
Core based statistical area (CBSAs replaced MSAs) |
CCPD |
Continuous cycling peritoneal dialysis |
CCR |
Cost-to-charge ratio |
CCU |
Coronary care unit |
CEO |
Chief Executive Officer |
CERT |
Comprehensive Error Rate Testing |
CFO |
Chief Financial Officer |
CFR |
Code of Federal Regulations |
CHOW |
Change of ownership |
CI |
Continuous improvement |
CIA |
Certified Internal Auditor |
CIO |
Chief Information Officer |
CMA |
Certified Management Accountant |
CMHC |
Community Mental Health Center |
CMI |
Case mix index |
CMS |
Centers for Medicare & Medicaid Services |
CO |
Central office (of CMS) |
COB |
Coordination of Benefits Contractor |
COBRA |
Consolidated Omnibus Budget Reconciliation Act |
CORF |
Comprehensive Outpatient Rehabilitation Facility |
CPA |
Certified Public Accountant |
CPE |
Continuing professional education |
CPE |
Contractor performance evaluation |
CPI |
Consumer Price Index |
CPT |
Current Procedural Terminology |
CR |
Change request |
CRC |
Cost report control (unit within PARD PARIS that accepts cost reports) |
CRNA |
Certified registered nurse anesthetist |
CROWD |
Contractor Reporting of Operational and Workload Data |
CTC |
Certified transplant center |
CWF |
Common working file |
CY |
Calendar year or current year |
D | |
---|---|
DAB |
Departmental Appeals Board (Area which covers Medicaid/Medi-Cal appeals) |
DCN |
Document control number |
DEFRA |
Deficit Reduction Act of 1984 |
DGME |
Direct Graduate Medical Education (or GME) |
DHHS |
Department of Health and Human Services |
DME |
Durable medical equipment |
DMEPOS |
Durable medical equipment, prosthetics, orthotics, and supplies |
DMERC |
Durable medical equipment regional carrier |
DNF |
Do not forward (initiative) |
DOB |
Date of birth |
DOJ |
Department of Justice |
DOS |
Date of service |
DPU |
Distinct part unit |
DRA |
Deficit Reduction Act of 2005 |
DRG |
Diagnosis related group |
DSH |
Disproportionate share hospital |
E | |
---|---|
EACH |
Essential Access Community Hospital |
eChimp |
Electronic Change Information Management Portal (CMS distributes CRs and TDLs) |
ECR |
Electronic cost report |
EDC |
Enterprise data center |
EDI |
Electronic data interchange |
EDR |
Electronic desk review |
EHR |
Electronic health record |
EIP |
Enterprise image processing |
EKG |
Electrocardiogram |
EOB |
Explanation of benefits |
EOMB |
Explanation of Medicare benefits |
EPO |
Erythropoietin |
ER |
Emergency room |
ERA |
Electronic remittance advice |
ESRD |
End-Stage Renal Disease |
EWP |
Electronic (excel) working papers |
F | |
---|---|
FAQ |
Frequently asked questions |
FAR |
Federal Acquisition Regulations (regulations governing costing methods for contracts) |
FCSO |
First Coast Service Options Inc. |
FFS |
Fee-for-service |
FI |
Fiscal intermediary (legacy Part A contractors, now replaced by MAC) |
FISS |
Fiscal Intermediary Standard System |
FOIA |
Freedom of Information Act |
FQHC |
Federally Qualified Health Center |
FR |
Federal Register |
FTE |
Full-time equivalent |
FY |
Fiscal year |
FYE |
Fiscal year end |
G | |
---|---|
GAAP |
Generally Accepted Accounting Principles |
GAAS |
Generally Accepted Auditing Standards |
GAGAS |
Generally Accepted Government Auditing Standards |
GAF |
Geographic adjustment factor |
GAO |
Government Accountability Office |
GAS |
Government Auditing Standards |
GI |
Gastrointestinal |
GL |
General ledger |
GME |
Graduate Medical Education (sometimes called DGME) |
H | |
---|---|
HCFA |
Health Care Financing Administration -- former name of CMS |
HCPCS |
Healthcare Common Procedure Coding System |
HCRIS |
Healthcare Cost Report Information System |
HFMA |
Healthcare Financial Management Association |
HFS |
Health Financial Systems |
HHA |
Home health agency |
HHRG |
Home Health Resource Group |
HHS |
Department of Health and Human Services |
HICN |
Health insurance claim number |
HIGLAS |
Healthcare Integrated General Ledger Accounting System (tracks payments to providers) |
HITECH |
Health Information Technology for Economic and Clinical Health Act |
HIPAA |
Health Insurance Portability and Accountability Act |
HMO |
Health maintenance organization |
HO |
Home office |
HOCS |
Home Office Cost Statement |
J | |
---|---|
JCAHO |
Joint Commission for the Accreditation of Health Care organizations |
JOA |
Joint operating agreement |
JSM |
Joint Signature Memorandum – replaced by TDL |
K | |
---|---|
KPMG |
KPMG CompuMax – cost reporting software |
L | |
---|---|
LCC |
Lower of cost or charges, (or lower of reasonable cost or customary charges) |
LCD |
Local Coverage Determination |
LIP |
Low Income Patient |
LOS |
Length of stay |
LTC |
Long-term care |
LTCH |
Long term care hospital |
LUPA |
Low utilization payment adjustment |
M | |
---|---|
M+C |
Medicare +Choice (Part C) |
MA |
Medicare Advantage (Part C) |
MAC |
Medicare administrative contractor |
MACJ1 |
MAC jurisdiction 1 (J1 will become JE) |
MCE |
Medicare code editor |
MCR |
Medicare cost report file created by HFS program |
MDH |
Medicare dependent hospital |
MedPac |
Medicare Payment Advisory Commission |
MIP |
Medicare Integrity Program |
MMORP |
Medicare Management Operations Review Program (maintained by BCBSA) |
MRI |
Magnetic resonance imaging |
MSA |
Metropolitan statistical area (outdated - replaced with CBSA) |
MSP |
Medicare secondary payer |
MSTAR |
Multi-user System for Tracking Audit and Reimbursement (Obsolete, see STAR) |
N | |
---|---|
NF |
Nursing facility |
NPI |
National provider identifier |
NPR |
Notice of program reimbursement |
O | |
---|---|
OASIS |
Outcome and assessment information set |
OBRA |
Omnibus Budget Reconciliation Act |
OCE |
Outpatient code editor |
OCR |
Original cost report |
OFM |
Office of Financial Management |
OGC |
Office of General Counsel (legal branch of CMS) |
OIG |
Office of Inspector General (investigative branch of CMS) |
OMB |
Office of Management and Budget (governmental agency which approves forms) |
OMNI |
Optimization Modernization through Networking and Innovation |
OPO |
Organ procurement organization |
OPPS |
Outpatient prospective payment system |
OR |
Operating room |
OSCAR |
Online survey certification and reporting |
OT |
Occupational therapy |
OTC |
Organ transplant centers |
P | |
---|---|
PAI |
Patient assessment instrument |
PARD |
Provider Audit and Reimbursement Department |
PARIS |
Provider Audit Reimbursement Integrated Services |
PECOS |
Provider Enrollment Chain and Ownership System |
PHI |
Protected health information |
PHP |
Partial hospitalization program |
PIP |
Periodic interim payment (method to pay providers biweekly, rather than by claim) |
PIP |
Performance improvement plan |
PPO |
Preferred provider organization |
PPS |
Prospective payment system |
PRA |
Per resident amounts |
PRRB |
Provider Reimbursement Review Board |
PRM |
Provider Reimbursement Manual |
PSC |
Program Safeguards Contractors |
PS&R |
Provider Statistics & Reimbursement report (summary of paid claims for cost report) |
PSF |
Provider-specific file |
PT |
Physical therapy |
PY |
Prior year |
Q | |
---|---|
QIO |
Quality Improvement Organization |
QMB |
Qualified Medicare beneficiary |
QMS |
Quality Management System |
R | |
---|---|
RA |
Remittance advice |
RAC |
Recovery audit contractor |
RAC |
Reimbursement Advisory Committee |
RFP |
Request for proposal |
RHC |
Rural health clinic |
RHHI |
Regional home health and hospice intermediary |
RN |
Registered nurse |
RNPR |
Revised Notice of Program Reimbursement |
RO |
Regional office |
ROE |
Return on equity |
RPCH |
Rural primary care hospitals |
RRC |
Rural referral center |
RT |
Respiratory therapy |
RUG |
Resource utilization group (PPS method of paying SNFs) |
S | |
---|---|
SAS |
Statement on Auditing Standards |
SCH |
Sole-community hospital |
SCHIP |
State Children’s Health Insurance Program |
SME |
Subject matter expert |
SNF |
Skilled Nursing Facility |
SOW |
Scope of work |
SOW |
Statement of work |
SSA |
Social Security Administration |
SSI |
Supplemental Security Income |
SSN |
Social Security Number |
STAR |
System for Tracking Audit and Reimbursement |
T | |
---|---|
TDL |
Technical Direction Letter (replaced JSM) – CMS directions to FI/MAC |
TEFRA |
Tax Equity and Fiscal Responsibility Act |
TIN |
Tax Identification Number |
TOPS |
Transition Outpatient Payments |
TS |
Tentative settlement |
U | |
---|---|
UB |
Uniform billing |
UDR |
Uniform Desk Review |
UFMS |
Unified Financial Management System |
UPIN |
Unique Physician Identification Number |
V | |
---|---|
VA |
Veterans Administration |
W | |
---|---|
WBT |
Web-based training |
WI |
Wage Index |