| AAHP |
American Association of Health Plans |
| ACE |
Automated Claims Evaluator |
| AHCA |
Agency for Health Care Administration |
| AHIMA |
American Health Information Management Association |
| AIMS |
Automated Investigation Management System |
| AMA |
American Medical Association |
| AMG |
Allied Management Group |
| ASC |
Accredited Standards Committee |
| CC |
Column 1/Column 2 |
| CC |
Compound/Comprehensive |
| CCI |
Correct Coding Initiative |
| CDT |
Current Dental Terminology |
| CHIP |
Child Health Insurance Program |
| CLIA |
Clinical Laboratory Improvement Amendments |
| CMP |
Civil Monetary Penalty |
| CMS |
Centers for Medicare and Medicaid Services |
| COB |
Coordination Of Benefits |
| CPT |
Current Procedural Terminology |
| DME |
Durable Medical Equipment |
| DOB |
Date Of Birth |
| DOS |
Date Of Service |
| DRG |
Diagnosis Related Group |
| DSM |
Diagnostic and Statistical Manual |
| EDI |
Electronic Data Interchange |
| F&A |
Fraud & Abuse |
| FWA |
Fraud, Waste & Abuse |
| HCCA |
Health Care Compliance Association |
| HCFA |
Health Care Finance Administration |
| HCPC |
Healthcare Common Procedure Code |
| HIE |
Health Information Exchange |
| HIMSS |
Health Information and Management Systems Society |
| HIPAA |
Health Insurance Portability and Accountability Act |
| HITSP |
Health Information Technology Standards Panel |
| HL7 |
Health Level 7 |
| HMO |
Health Maintenance Organization |
| ICD |
International Classification of Diseases |
| ICN |
Internal Control Number |
| IPA |
Independent Physicians Associations |
| JIP |
Joint Interface Plan |
| LCD |
Local Coverage Determination |
| LMRP |
Local Medical Regional Policy |
| MDC |
Major Diagnostic Category |
| ME |
Mutually Exclusive |
| MFCU |
Medicaid Fraud and Control Unit |
| MIP |
Medicaid Integrity Program |
| MSO |
Management Services Organization |
| MUE |
Medically Unlikely Edit |
| NCCI |
National Correct Coding Initiative |
| NCPDP |
National Council for Prescription Drug Programs |
| NDC |
National Drug Code |
| NHCAA |
National Health Care Anti-fraud Association |
| NHIN |
National Health Information Network |
| NPI |
National Provider Identifier |
| NSF |
National Standard Format |
| OIG |
Office of Inspector General |
| ONCHIT |
Office of the National Coordinator for Health Information Technology |
| OPIC |
Office of Public Insurance Counsel |
| OTC |
Over The Counter |
| PBM |
Prescription drug Benefits Management |
| PCP |
Primary Care Physician |
| PPS |
Prospective Payment System |
| RAC |
Recovery Audit Contractor |
| RVU |
Relative Value Unit |
| SIU |
Special Investigation Unit |
| SPIN |
Standard Prescriber Identification Number |
| SSI |
Supplemental Security Income |
| SSN |
Social Security Number |
| STAR |
State of Texas Access Reform |
| TAA |
Texas Access Alliance |
| TPA |
Third Party Administrator |
| TPA |
Trading Partner Agreement |
| UB |
Uniform Bill |
| UB-92 |
Uniform Bill form 92 |
| UPIN |
Unique Physician Identification Number |