MEDICAID ACRONYMS


The following acronyms are used frequently when dealing with Medicaid issues. For your convenience, we have compiled a list of definitions for these acronyms.

ACRONYMS DEFINITIONS
ADJ Adjustment

BHSF

Bureau of Health Services Financing

CCN

Card Control Number

CCQP

CommunityCARE Quality Profiles

CCR

CommunityCARE Reports

CCUR

CommunityCARE Utilization Reports

CDI

Clinical Data Inquiry

CMS

Center for Medicaid & Medicare Services

CPT

Current Procedural Terminology

DHH

Department of Health & Hospitals

DME

Durable Medical Equipment

EFT

Electronic Funds Transfer

EIN

Employer ID number

EMC

Electronic Media Claims

EOB

Explanation of Benefits

EPA

Electronic Prior Authorization

EPSDT

Early and Periodic Screening, Diagnosis and Treatment

ERA

Electronic Referral Authorization

ERA

Electronic Remittance Advice

ERARemit835

Electronic 835 Remittance Advice

FQHC

Federally Qualified Health Center

GHIPP

Group Health Insurance Payment Program

HCFA

Health Care Financing Administration, 
recently renamed CMS

HCFA-1500 Universal Claim Form for Physicians, DME Suppliers, Laboratories, Chiropractors, and Podiatrists

HCPCS

Health Care Procedure Coding Scheme

HIPAA

Health Insurance Portability & Accountability Act

HMO Health Management Organization

ICD-9-CM

International Classification of Diseases, 
Clinical Modification

ICN

Internal Control Number

LTC

Long Term Care

MAPIL

Medical Assistance Program Integrity Law

MEVS

Medicaid Eligibility Verification System

MMIS

Medicaid Management Info System

MR/DD WAIVER

Mentally Retarded/Developmentally Disabled Waiver

NCPDP

National Council for Prescription Drug Problems

Online1099

Online 1099 Admin Portal

OnlineRA

Online Remittance Advice Portal

PA Prior Authorization

PBM

Pharmacy Benefits Management

PCA

Personal Care Attendant

PCP

Primary Care Physician

PE-50 FORM

Provider Enrollment Form

POS

Point of Sale

PrecertInquiry

Online Search for a Louisiana Medicaid Recipient Hospital Stay (Precertification)

QMB

Qualified Medicare Beneficiary

RA

Remittance Advice

REOMB

Recipient's Explanation of Medical Benefits

REVS

Recipient Eligibility Verification System

RHC

Rural Health Clinic

SSA

Social Security Administration

SSI Social Security Income

SURS

Surveillance Utilization Review System

TIN

Taxpayer ID number

TPL

Third Party Liability

UB-92

Universal Billing - 92 Form