Health Care Acronyms

ACA: (Patient Protection and) Affordable Care Act
ACO: Accountable Care Organization
AD&D: Accidental Death and Dismemberment
ADA: American with Disabilities Act of 1990
ALOS: Average Length of Stay
AMA: American Medical Association
APTC: Advanced Premium Tax Credit
ASC: Ambulatory Surgery Center
Auth: Authorization
BOI: Bureau of Insurance
CDHP: Consumer-Directed Health Plan
CHAMPUS: Civilian Hospital and Medical Program of the Uniformed Service. Now known as Tricare.
CHIP: Children's Health Insurance Program
CIN: Clinically Integrated Network
CMS: Centers for Medicare and Medicaid Services (previously HCFA)
COB: Coordination of Benefits
COBRA: Consolidated Omnibus Reconciliation Act (extension of coverage)
COI: Certificate of Insurance
CPT: Current Procedural Terminology (Level 1 codes)
DMAS: Department of Medical Assistance Services
DME: Durable Medical Equipment
DOL: Department of Labor
DOS: Date of Service
E & L: Exclusions and Limitations
EAP: Employee Assistance Program
EMT: Emergency Medical Technician
ENT: Ears, Nose and Throat
EOB: Explanation of Benefits
EOC: Evidence of Coverage (HMO / POS Plan Documentation)
ER: Emergency Room
ERISA: Employee Retirement Income Security Act
FAMIS: Family Access to Medical Insurance Security Plan
FDA: Food and Drug Administration
FEHBP: Federal Employee Health Benefit Plan
FFS: Fee for Service
FMLA: Family and Medical Leave Act
FSA: Flexible Spending Account
HDHP: High-Deductible Health Plan
HEDIS®: Health Plan Employer Data and Information Set
HIPAA: Health Insurance Portability and Accountability Act
HMO: Health Maintenance Organization
HRA: Health Reimbursement Account
HSA: Health Savings Account
ICU: Intensive Care Unit
IRF: Inpatient Reading Fee
IUD: Intrauterine Device
IV: Intravenous
JCAHO: Joint Commission on the Accreditation of Hospital Organizations
LOS: Length of Stay
LPN: Licensed Practical Nurse
LTD: Long Term Disability
Max: Maximum
MD: Medical Doctor
MOOP: Maximum Out of Pocket
MRI: Magnetic Resonance Imaging
NAIC: National Association of Insurance Commissioners
NCQA: National Committee for Quality Assurance
NIMH: National Institute of Mental Health
Non-par: Not participating (out-of-network)
NPI: National Provider Identifier
OB: Obstetrician
OOA: Out of Area
OOP: Out of Pocket
OSHA: Occupational Safety and Health Act
OTC: Over the Counter
OV: Office Visit
P&T: Pharmacy & Therapeutics Committee
Par: Participating
PCMH: Patient Centered Medical Home
PCP: Primary Care Physician
PHA: Personal Health Assessment
PHI: Protected Health Information
POA: Power of Attorney
POS: Point of Service
PPACA: Patient Protection and Affordable Care Act
PPO: Preferred Provider Organization
Pre-auth: Pre-Authorization
Pre-X: Pre-existing Conditions
PSA: Prostate Screening Antigen
PT: Physical Therapy
QHP: Qualified Health Plan
Remit: Remittance
Retro: Retroactive
RN: Registered Nurse
ROI: Release of Information
RX: Prescription
SBC: Uniform Summary of Benefits and Coverage
SF: Self-Funded
SNF: Skilled Nursing Facility
ST: Speech Therapy
STD: Short-Term Disability
TEFRA: Tax Equity and Fiscal Responsibility Act of 1982
TPA: Third-Party Administrator
TRICARE: Managed Healthcare System for military families
UCC: Urgent Care Center
URI: Upper Respiratory Infection
VA Hospital: Veterans Administration Hospital
WC: Worker's Compensation
WH: Withhold
WIC: Women, Infants and Children (supplemental food program)
YTD: Year to Date

 

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