The healthcare industry can be complicated. The uniqueness of the language used in the industry can further complicate things if you are unfamiliar with it. DataMetrix has compiled this list of acronyms to help understand not only our company, products and services, but also the healthcare industry in general.
AAMAS - American Association of Medical Audit Specialists
AHIP - America's Health Insurance Plans
ANSI - American National Standards Institute
APC - Ambulatory Payment Classification
CASE - Claims Analysis Secure Engine
CMAS - Certified Medical Audit Specialist
CMS - Centers for Medicare and Medicaid Services
COBRA - Consolidated Omnibus Budget Reconciliation Act
CRA - Clinical Review
DBA - Database Administrator
DD - Direct Data
DRG - Diagnosis Related Groupings
ER - Emergency Room
ESRD - End Stage Renal Disease
HAC - Hospital Acquired Conditions
HBA - Hospital Bill Audit
HIPAA - Health Insurance Portability and Accountability Act
HMO - Health Maintenance Organization
ICD-9 - International Classification of Diseases
IPO - Independent Practice Organization
MCO - Managed Care Organization
MEQC - Medicaid Eligibility Quality Control
MITA - Medicaid Information Technology Architecture
MMCS - Medicaid Managed Care System
MMIS - Medicaid Management Information System
MRN - Medical Record Number
NCCI - National Correct Coding Initiative
NDC - National Drug Code
NPI - National Provider Identifier
PCN - Primary Care Network
PCP - Primary Care Provider
PDL - Preferred Drug List
QA - Quality Assurance
RN - Registered Nurse
SLA - Service Level Agreement
SME - Subject Matter Expert
SNF - Skilled Nursing Facility
SOAP - Simple Object Access Protocol
SOP - Standard Operating Procedure
SOW - Statement of Work
TPL - Third Party Liability
WCC - Western Claim Conference
XML - Extensible Markup Language
YTD - Year-to-Date