Medical Insurance Abbreviations Flashcards
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Questions and Answers

What does the abbreviation NPP stand for?

  • National Provider Identifier
  • Normal Patient Protocol
  • Nonparticipating Provider
  • Notice of Privacy Practice (correct)

    • What is the meaning of the abbreviation OCR?

    Office of Civil Rights

    What does COB stand for?

    Coordination of Benefits

    What does EP stand for in medical terms?

    <p>Established Patient</p> Signup and view all the answers

    Define NP in the context of medical terminology.

    <p>New Patient</p> Signup and view all the answers

    What does NonPAR mean?

    <p>Nonparticipating Provider</p> Signup and view all the answers

    What is a PAR?

    <p>Participating Provider</p> Signup and view all the answers

    What does RTCA stand for?

    <p>Real Time Claims Adjudication</p> Signup and view all the answers

    What does CC mean?

    <p>Chief Complaint</p> Signup and view all the answers

    What does NEC stand for?

    <p>Not Elsewhere Classified</p> Signup and view all the answers

    What is the meaning of NOS?

    <p>Not Otherwise Specified</p> Signup and view all the answers

    What does CPT stand for?

    <p>Current Procedural Terminology</p> Signup and view all the answers

    Define DME.

    <p>Durable Medical Equipment</p> Signup and view all the answers

    What does E/M Codes refer to?

    <p>Evaluation and Management Codes</p> Signup and view all the answers

    What does HCPCS stand for?

    <p>Healthcare Common Procedure Coding System</p> Signup and view all the answers

    What is the Professional Component abbreviated as?

    <p>PC</p> Signup and view all the answers

    What does TC mean?

    <p>Technical Component</p> Signup and view all the answers

    What does NUCC stand for?

    <p>National Uniform Claim Committee</p> Signup and view all the answers

    Define ASO.

    <p>Administrative Services Only</p> Signup and view all the answers

    What is AP in financial terms?

    <p>Accounts Payable</p> Signup and view all the answers

    What does AR stand for?

    <p>Accounts Receivable</p> Signup and view all the answers

    What does CDHP mean?

    <p>Consumer Driven Health Plan</p> Signup and view all the answers

    What does EHR stand for?

    <p>Electronic Health Records</p> Signup and view all the answers

    What does HIT represent?

    <p>Health Information Technology</p> Signup and view all the answers

    What is the meaning of HMO?

    <p>Health Maintenance Organization</p> Signup and view all the answers

    Define MCO.

    <p>Managed Care Organization</p> Signup and view all the answers

    What does PMPM stand for?

    <p>Per Member Per Month</p> Signup and view all the answers

    What does PMP mean?

    <p>Practice Management Program</p> Signup and view all the answers

    What does ACO stand for?

    <p>Accountable Care Organization</p> Signup and view all the answers

    What does BA mean in the healthcare context?

    <p>Business Associate</p> Signup and view all the answers

    What is CMS?

    <p>Centers for Medicare and Medicaid Services</p> Signup and view all the answers

    What does CE stand for?

    <p>Covered Entity</p> Signup and view all the answers

    Define DRS in medical terms.

    <p>Designated Record Set</p> Signup and view all the answers

    What does EDI stand for?

    <p>Electronic Data Interchange</p> Signup and view all the answers

    What does E/M stand for?

    <p>Evaluation and Management</p> Signup and view all the answers

    What does HIE represent?

    <p>Health Information Exchange</p> Signup and view all the answers

    What does HITECH mean?

    <p>Health Information Technology for Economic and Clinical Health Act</p> Signup and view all the answers

    What does NPI stand for?

    <p>National Provider Identifier</p> Signup and view all the answers

    What does NCD stand for?

    <p>National Coverage Determination</p> Signup and view all the answers

    What does PQRS stand for?

    <p>Physician Quality Reporting System</p> Signup and view all the answers

    What does CHIP stand for?

    <p>Children's Health Insurance Plan</p> Signup and view all the answers

    What does EPSDT mean?

    <p>Early and Periodic Screening, Diagnosis and Treatment</p> Signup and view all the answers

    What is FMAP?

    <p>Federal Medical Assistance Program</p> Signup and view all the answers

    What does MIP stand for?

    <p>Medicaid Integrity Program</p> Signup and view all the answers

    What is TANF?

    <p>Temporary Assistance for Needy Families</p> Signup and view all the answers

    Define MTF in healthcare.

    <p>Military Treatment Facility</p> Signup and view all the answers

    What does NAS stand for?

    <p>Nonavailability Statement</p> Signup and view all the answers

    What does PCM mean?

    <p>Primary Care Manager</p> Signup and view all the answers

    What does TRS stand for?

    <p>TRICARE Reserve Select</p> Signup and view all the answers

    What is CHAMPVA?

    <p>Civilian Health and Medical Program of Department of Veterans Affairs</p> Signup and view all the answers

    What does CHAMPUS stand for?

    <p>Civilian Health and Medical Program of the Uniformed Services</p> Signup and view all the answers

    What does ERISA mean?

    <p>Employee Retirement Income Security Act</p> Signup and view all the answers

    What does EOC stand for?

    <p>Episode of Care</p> Signup and view all the answers

    What does FEHB stand for?

    <p>Federal Employees Health Benefits</p> Signup and view all the answers

    Define FSA.

    <p>Flexible Savings Account</p> Signup and view all the answers

    What does GHP stand for?

    <p>Group Health Plan</p> Signup and view all the answers

    What does HRA stand for?

    <p>Health Reimbursement Account</p> Signup and view all the answers

    What does HSA mean?

    <p>Health Savings Account</p> Signup and view all the answers

    What does IHP stand for?

    <p>Individual Health Plan</p> Signup and view all the answers

    What does ABN stand for?

    <p>Advance Beneficiary Notice of Noncoverage</p> Signup and view all the answers

    What does AWV stand for?

    <p>Annual Wellness Visit</p> Signup and view all the answers

    What does CWF stand for?

    <p>Common Working File</p> Signup and view all the answers

    Define IPPE in the healthcare field.

    <p>Initial Preventive Physical Examination</p> Signup and view all the answers

    What does LCD stand for?

    <p>Local Coverage Determination</p> Signup and view all the answers

    What does MSA stand for?

    <p>Medical Savings Account</p> Signup and view all the answers

    Study Notes

    Medical Insurance Abbreviations

    • NPP: Notice of Privacy Practice; outlines how health information is used and shared.
    • OCR: Office of Civil Rights; enforces civil rights laws in healthcare.
    • COB: Coordination of Benefits; the process to determine the order of payment when multiple insurances are involved.
    • EP: Established Patient; a patient who has received care from the provider within a specified time frame.
    • NP: New Patient; a patient who has not received care from the provider previously.
    • NonPAR: Nonparticipating Provider; a provider who does not have a contract with a health plan.
    • PAR: Participating Provider; a provider who has an agreement to provide services to a health plan's members.
    • RTCA: Real Time Claims Adjudication; immediate processing of claims during a patient encounter.
    • CC: Chief Complaint; the primary reason for a patient's visit.
    • NEC: Not Elsewhere Classified; used to indicate a specific code is not available for a diagnosis.
    • NOS: Not Otherwise Specified; indicates when detailed diagnosis is missing.
    • CPT: Current Procedural Terminology; codes for procedures and services provided by healthcare professionals.
    • DME: Durable Medical Equipment; medical equipment that can withstand repeated use.
    • E/M Codes: Evaluation and Management Codes; codes for patient visits that require assessment and treatment.
    • HCPCS: Healthcare Common Procedure Coding System; a set of codes for medical items not covered by CPT.
    • PC: Professional Component; the portion of a billing related to the professional service provided.
    • TC: Technical Component; the billing for technical services associated with tests.
    • NUCC: National Uniform Claim Committee; organization that maintains the guidelines for electronic claims submissions.
    • ASO: Administrative Services Only; services provided to manage health insurance plans without assuming risk.
    • AP: Accounts Payable; liabilities of a company or organization for amounts owed to suppliers.
    • AR: Accounts Receivable; money owed to a business for goods or services delivered.
    • CDHP: Consumer Driven Health Plan; a health insurance plan that allows consumers more control over their healthcare choices.
    • EHR: Electronic Health Records; digital records of patient health information.
    • HIT: Health Information Technology; technologies used to store, share, and analyze health information.
    • HMO: Health Maintenance Organization; provides health services for a fixed annual fee.
    • MCO: Managed Care Organization; integrates the financing and delivery of healthcare services.
    • PMPM: Per Member Per Month; a billing term that reflects monthly costs for each member in a plan.
    • PMP: Practice Management Program; software solutions for managing a healthcare practice's operations.
    • ACO: Accountable Care Organization; a group of healthcare providers that work together to deliver coordinated care.
    • BA: Business Associate; an entity that performs functions on behalf of a covered entity that involves the use of protected health information.
    • CMS: Centers for Medicare and Medicaid Services; federal agency that administers these programs.
    • CE: Covered Entity; healthcare providers, health plans, and healthcare clearinghouses that transmit health information.
    • DRS: Designated Record Set; a group of records maintained by a healthcare provider.
    • EDI: Electronic Data Interchange; the interchange of data in a standardized format between organizations.
    • E/M: Evaluation and Management; a category of codes used for billing patient assessments.
    • HIE: Health Information Exchange; the electronic sharing of health information among organizations.
    • HITECH: Health Information Technology for Economic and Clinical Health Act; promotes the adoption of health information technology.
    • NPI: National Provider Identifier; unique identification number assigned to healthcare providers.
    • NCD: National Coverage Determination; decision by CMS on whether a service is covered by Medicare.
    • PQRS: Physician Quality Reporting System; program that encourages healthcare providers to report information on the quality of care.
    • CHIP: Children's Health Insurance Plan; provides health coverage to eligible children in families with incomes too high to qualify for Medicaid.
    • EPSDT: Early and Periodic Screening, Diagnosis and Treatment; Medicaid benefit for children under 21.
    • FMAP: Federal Medical Assistance Program; provides federal funding for state Medicaid programs.
    • MIP: Medicaid Integrity Program; ensures integrity of Medicaid services provided.
    • TANF: Temporary Assistance for Needy Families; federal assistance program for low-income families.
    • MTF: Military Treatment Facility; healthcare provider for military personnel and their families.
    • NAS: Nonavailability Statement; documentation of healthcare service not available at military treatment facilities.
    • PCM: Primary Care Manager; healthcare provider who oversees a patient's care in managed care systems.
    • TRS: TRICARE Reserve Select; health insurance program for select reservists and their families.
    • CHAMPVA: Civilian Health and Medical Program of the Department of Veterans Affairs; health care benefits for eligible dependents of veterans.
    • CHAMPUS: Civilian Health and Medical Program of the Uniformed Services; now known as TRICARE.
    • ERISA: Employee Retirement Income Security Act; federal law that sets minimum standards for pension plans.
    • EOC: Episode Of Care; a series of healthcare-related interactions for a specific condition or treatment.
    • FEHB: Federal Employees Health Benefits; health benefits program for federal employees and retirees.
    • FSA: Flexible Savings Account; a pre-tax financial account for healthcare-related expenses.
    • GHP: Group Health Plan; health plan sponsored by an employer.
    • HRA: Health Reimbursement Account; employer-funded account for healthcare expenses.
    • HSA: Health Savings Account; tax-advantaged medical savings account for individuals with high-deductible health plans.
    • IHP: Individual Health Plan; health insurance purchased by individuals rather than through an employer.
    • ABN: Advance Beneficiary Notice of Noncoverage; notice informing beneficiaries that Medicare may not pay for a service.
    • AWV: Annual Wellness Visit; yearly visit established by Medicare for preventive service.
    • CWF: Common Working File; database containing Medicare claims history.
    • IPPE: Initial Preventive Physical Examination; a benefit for Medicare beneficiaries for preventive screening.
    • LCD: Local Coverage Determination; guidelines for coverage based on local Medicare contractors.

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    Test your knowledge of medical insurance abbreviations with these flashcards. Each card presents a term alongside its definition, helping you understand important concepts in healthcare. Ideal for students and professionals in the medical field.

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