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CareFirst.com Acronyms

Acronyms

Click here to view a listing of health care definitions.

A

AB

 Allowed Benefit
AHA American Hospital Association
AMA American Medical Association
ASC Administrative Service Contract or Ambulatory Surgical Center
ASO Administrative Services Only
B
BCBSA Blue Cross and Blue Shield Association
BCBSDE Blue Cross Blue Shield of Delaware
C
CMS Centers for Medicare & Medicaid Services
CNM Certified Nurse Midwife
COB Coordination of Benefits
COBRA Consolidated Omnibus Budget Reconciliation Act of 1986
COC Certificate of Coverage
COMP Comprehensive Insurance
CPT Current Procedural Terminology
CRNA Certified Registered Nurse Anesthetist
CRNP Certified Registered Nurse Practitioner
D
DEFRA Deficit Reduction Act of 1984
DHMH Department of Health and Mental Hygiene
DHMO Dental Health Maintenance Organization
DME Durable Medical Equipment
DMO Dental Maintenance Organization
DP Direct Pay/Direct Processing
DRG Diagnosis Related Group
E
ECF Extended Care Facility
EOB Explanation of Benefits
EOMB Explanation of Medicare Benefits
ERISA Employee Retirement Income Security Act
ER/ED Emergency Room/Emergency Department
E&B/EAB Enrollment and Billing
F
FDA Food and Drug Administration
FEP/FEBHP Federal Employee Program/Federal Employee Benefits Health Plan
FOP Field of Practice
H
HCACC Health Care Access and Cost Commission
HCPCS HCFA Common Procedure Coding System
HIAA Health Insurance Association of America
HIPAA Health Insurance Portability and Accountability Act of 1996
HMO Health Maintenance Organization
HSCRC Health Services Cost Review Commission
I
ICD International Classification of Diseases
ICM Individual Case Management
IP Inpatient
IPA Independent or Individual Practice Association
J
JCAHO Joint Commission on Accreditation of Healthcare Organizations
L
LOS Length of Stay
LPN Licensed Practical Nurse
LPT Licensed Physical Therapist
M
MAC Maximum Allowable Cost/Maximum Annual Copayment
MB Medical Benefits
MCO Managed Care Organization
MCS Managed Care System
MED-CHI Medical & Chirurgical Facility of Maryland
MHA Maryland Hospital Association
MHIN Maryland Health Information Network
MM Major Medical
MPOS Maryland Point of Service
MSGR Maryland Small Group Reform
MSSOP Mandatory Second Surgical Opinion Program
N
NAIC National Association of Insurance Commissioners
NASCO National Account Service Corporation
NCQA National Committee for Quality Assurance
NDC National Drug Code
NP Nurse Practitioner
O
OBRA Omnibus Budget Reconciliation Act of 1986
OCL Outstanding Claims Liability
OOA/ITS Out-of-Area Program/Inter-Plan Teleprocessing Services
OOP Out-of-Pocket
OP Outpatient
OPAP Outpatient Pre-Treatment Authorization Plan
OPL Other Party Liability
P
PAR Participating (plan, hospital, physician, etc.)
PCP Primary Care Physician
PDR Physicians Desk Reference
PIP Personal Injury Protection/Proposal and Installment Process
POS Point-of-Service plans
PPA Preferred Provider Arrangement
PPN Preferred Provider Network
PPO Preferred Provider Organization
PT Physical Therapist
Q
QA Quality Assurance
QI Quality Improvement
R
RN Registered Nurse
RPT Registered Physical Therapist
RX Prescription Drug
S
SEGO Small Employer Group Options
SNF Skilled Nursing Facility
SRO Self Referral Option
SSA Social Security Administration
SSO Second Surgical Opinion
T
TEFRA Tax Equity and Fiscal Responsibility Act of 1982
TPA Third Party Administrator
U
UR Utilization Review
V
VSSOP Voluntary Second Surgical Opinion
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Serving Maryland, the District of Columbia and portions of Virginia. CareFirst BlueCross BlueShield is the shared business name of CareFirst of Maryland, Inc. and Group Hospitalization and Medical Services, Inc. CareFirst BlueChoice, Inc., an affiliate company, also offers health benefit products and services on this site.

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