PROVIDER SUPPORT

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
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
EPSDT	Early and Periodic Screening, Diagnosis and Treatment
ERA	Electronic 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
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
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