[{"id":200,"acronym":"ab1324","definition":"It is a State Calif bill that tells HMO groups that if the provider obtained a prior Authorization, then we have to consider payment even when the member is Termed/Not Eligible, IF the provider submits proof of Elig verification prior to the DOS."},{"id":5,"acronym":"aca","definition":"Affordable Care Act"},{"id":6,"acronym":"aco","definition":"Accountable Care Organization"},{"id":7,"acronym":"ada","definition":"Americans with Disability Act"},{"id":8,"acronym":"adea","definition":"Age Discrimination in Employment Act"},{"id":9,"acronym":"adum","definition":"Automated Data Update Machine"},{"id":10,"acronym":"aevs","definition":"Automated Eligibility Verification System"},{"id":11,"acronym":"alf","definition":"Assisted Living Facility"},{"id":12,"acronym":"alos","definition":"Average Length of Stay"},{"id":13,"acronym":"ama","definition":"Against Medical Advice"},{"id":14,"acronym":"aor","definition":"Appointment of Representative"},{"id":15,"acronym":"api","definition":"Application Programming Interface"},{"id":203,"acronym":"baa","definition":"Business Associate Agreement"},{"id":16,"acronym":"bcbs","definition":"Blue Cross Blue Shield"},{"id":17,"acronym":"cap","definition":"Corrective Action Plan "},{"id":214,"acronym":"carc","definition":"Claims Adjustment Reason Code"},{"id":18,"acronym":"ccm","definition":"Complex Case Management"},{"id":19,"acronym":"cde","definition":"Certified Diabetic Educator"},{"id":20,"acronym":"cdtm","definition":"Collaborative Drug Therapy Management"},{"id":21,"acronym":"cfr","definition":"Code of Federal Regulations"},{"id":213,"acronym":"cgt","definition":"Cedar Gate Technologies"},{"id":23,"acronym":"clhf","definition":"Congregate Living Health Facility"},{"id":31,"acronym":"cm","definition":"Commercial Members or Claims Manager or Case Management"},{"id":24,"acronym":"cmc","definition":"Cal MediConnect"},{"id":2,"acronym":"cms","definition":"Centers for Medicare and Medicaid Services"},{"id":26,"acronym":"coa","definition":"Care for Older Adults. Groups Medicare 5 star measures: Medication Review"},{"id":27,"acronym":"cob","definition":"Coordination Of Benefits"},{"id":28,"acronym":"coc","definition":"Continuity of Care"},{"id":29,"acronym":"codac","definition":"Consolidated Data Checker"},{"id":30,"acronym":"corf","definition":"Comprehensive Outpatient Rehabilitation Facility"},{"id":197,"acronym":"cphims","definition":"Certified Professional in Healthcare Information and Management Systems. A certification offered by <https://www.himss.org/resources-certification/cphims|HIMSS>"},{"id":32,"acronym":"cpt","definition":"Current Procedural Terminology"},{"id":33,"acronym":"crd","definition":"Crystal Reports Distributor"},{"id":34,"acronym":"crvs","definition":"California Relative Value Scale"},{"id":35,"acronym":"csa","definition":"Clinical Social Assessment"},{"id":210,"acronym":"csdn","definition":"Commercial Service Denial Notice"},{"id":36,"acronym":"csnp","definition":"Chronic Special Needs Program"},{"id":38,"acronym":"dce","definition":"Direct Contracting Entity"},{"id":39,"acronym":"ddr","definition":"Daily Disposition Referral"},{"id":40,"acronym":"denc","definition":"Detailed Explanation of Non-Coverage"},{"id":41,"acronym":"dhs","definition":"Department of Human and Health Services"},{"id":42,"acronym":"dlq","definition":"Delinquent"},{"id":43,"acronym":"dm","definition":"Disease Management or Diabetic Management"},{"id":44,"acronym":"dme","definition":"Durable Medical Equipment"},{"id":46,"acronym":"dmhc","definition":"Department of Managed Healthcare"},{"id":45,"acronym":"dmr","definition":"Direct Member Reimbursement"},{"id":47,"acronym":"dnc","definition":"Do Not Contact"},{"id":48,"acronym":"dns","definition":"Do Not Send"},{"id":49,"acronym":"dofr","definition":"Division of Financial Responsibility"},{"id":50,"acronym":"dop","definition":"Date of Payment"},{"id":51,"acronym":"dot","definition":"Directly Observed Therapy"},{"id":52,"acronym":"dou","definition":"Direct Obsevation Unit. Although 'Observation' is in the phrase it doesn't mean OBS."},{"id":53,"acronym":"dow","definition":"Day of the Week"},{"id":54,"acronym":"dpoa","definition":"Durable Power of Attorney"},{"id":55,"acronym":"drg","definition":"Diagnosis Related Group"},{"id":56,"acronym":"dsnp","definition":"Dual Special needs Program"},{"id":57,"acronym":"dx","definition":"Abbreviation for diagnosis"},{"id":58,"acronym":"easy","definition":"Email Answer SYstem"},{"id":59,"acronym":"ehr","definition":"Electronic Health Record"},{"id":60,"acronym":"eiod","definition":"Expedited Initial Organization Determination"},{"id":61,"acronym":"em","definition":"Exchange Members"},{"id":62,"acronym":"emr","definition":"Electronic Medical Record"},{"id":63,"acronym":"eob","definition":"Explanation of Benefits"},{"id":64,"acronym":"eod","definition":"Expedited Organizational Determinations - also referred to as **Urgent**"},{"id":65,"acronym":"eop","definition":"Explanation of Payment"},{"id":67,"acronym":"ephi","definition":"Electronic Protected Health Information"},{"id":68,"acronym":"epls","definition":" Excluded Parties List System"},{"id":69,"acronym":"er","definition":"Emergency Room"},{"id":70,"acronym":"erec","definition":"Expedited Pre-service Reconsiderations"},{"id":71,"acronym":"erisa","definition":"Employee Retirement Income Security Act (1974)"},{"id":72,"acronym":"esrd","definition":"End Stage Renal Disease"},{"id":208,"acronym":"etd","definition":"Encounter Transmittal Date"},{"id":73,"acronym":"fca","definition":"False Claims Act"},{"id":74,"acronym":"fdrs","definition":"First-tier"},{"id":75,"acronym":"feha","definition":"California Fair Employment and Housing Act"},{"id":76,"acronym":"ferpa","definition":"Family Educational Rights and Privacy Act"},{"id":77,"acronym":"ffs","definition":"Fee for service"},{"id":78,"acronym":"fhc","definition":"Family Hospice Care"},{"id":80,"acronym":"ftf","definition":"Face to 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System"},{"id":94,"acronym":"hitech","definition":"Health Information Technology for Economic and Clinical Health Act"},{"id":95,"acronym":"hitrust","definition":"Health Information Trust Alliance "},{"id":96,"acronym":"hmo","definition":"Health Maintenance Organization"},{"id":97,"acronym":"hra","definition":"Health Risk Assessment"},{"id":98,"acronym":"ic","definition":"Immediate Care"},{"id":99,"acronym":"icd","definition":"International Classification of Diseases"},{"id":100,"acronym":"ice","definition":"Industry Collaborative Effort"},{"id":101,"acronym":"icm","definition":"Intense Case Management"},{"id":102,"acronym":"icp","definition":"Individual Care Plan"},{"id":103,"acronym":"ict","definition":"Interdisciplinary Care Team"},{"id":104,"acronym":"ihss","definition":"In Home Support Services"},{"id":207,"acronym":"iipp","definition":"Injury and Illness Prevention Program"},{"id":105,"acronym":"imo","definition":"Intelligent Medical Objects"},{"id":106,"acronym":"imr","definition":"Independent Medical Review"},{"id":107,"acronym":"isnp","definition":"Institutional Special Needs Plan"},{"id":109,"acronym":"kpi","definition":"Key Performance Indicator"},{"id":113,"acronym":"lcsw","definition":"Licensed Clinical Social Worker"},{"id":110,"acronym":"leie","definition":"List of Excluded Individuals/Entities"},{"id":111,"acronym":"loa","definition":"Letter of Agreement"},{"id":112,"acronym":"loinc","definition":"Logical Observation Identifiers Names and Codes"},{"id":114,"acronym":"los","definition":"Length of Stay"},{"id":195,"acronym":"lou","definition":"Letter of Undertaking"},{"id":193,"acronym":"ltss","definition":"Long Term Support Services"},{"id":115,"acronym":"ma","definition":"Medicare Advantage"},{"id":116,"acronym":"mapd","definition":"Medicare Advantage plan that offers prescription drug coverage"},{"id":117,"acronym":"mbi","definition":""},{"id":118,"acronym":"md","definition":"Medical Doctor"},{"id":212,"acronym":"mds","definition":"Multiple Date Stamps"},{"id":119,"acronym":"mesr","definition":"Medicaid Expedited Service Authorization Requests "},{"id":120,"acronym":"mfs","definition":"Medicare Fee Schedule"},{"id":121,"acronym":"mips","definition":"Merit-based Incentive Payment System"},{"id":122,"acronym":"mln","definition":"Medicare Lerning Network®"},{"id":123,"acronym":"mmp","definition":"Medicare-Medicaid Plan"},{"id":124,"acronym":"mms","definition":"Medication Management Services"},{"id":125,"acronym":"moc","definition":"Model of Care"},{"id":196,"acronym":"mou","definition":"Memorandum of Understanding"},{"id":126,"acronym":"mppr","definition":"Multiple Procedure Payment Reduction"},{"id":127,"acronym":"mssr","definition":"Medicare Standard Service Authorization Requests "},{"id":128,"acronym":"mtr","definition":"Monthly Timeliness Report - Claims"},{"id":129,"acronym":"ncm","definition":"Nephrology Case Management"},{"id":130,"acronym":"ndc","definition":"National Drug Code"},{"id":211,"acronym":"ndmc","definition":"Notice of Denial of Medical Coverage"},{"id":131,"acronym":"nomnc","definition":"Notice of Medicare Non-Coverage"},{"id":132,"acronym":"np","definition":"Nurse Practitioner"},{"id":133,"acronym":"npi","definition":"National Provider Identifier"},{"id":134,"acronym":"ntuc","definition":"Not Taken Under Care"},{"id":135,"acronym":"obs","definition":"Observation"},{"id":136,"acronym":"odag","definition":"Organization Determinations and Grievances"},{"id":137,"acronym":"odr","definition":"Organization Determinations and Reconsiderations"},{"id":138,"acronym":"oig","definition":"Office of the Inspector General"},{"id":139,"acronym":"oipa","definition":"Oasis IPA (precursor to DOHC)"},{"id":140,"acronym":"ooa","definition":"Out of Area"},{"id":199,"acronym":"opom","definition":"Operational Performance Oversight and Monitoring"},{"id":141,"acronym":"opps","definition":"Outpatient Prospective Payment System"},{"id":142,"acronym":"ors","definition":"Outreach Services"},{"id":143,"acronym":"osha","definition":"Occupational Safety and Health Administration"},{"id":145,"acronym":"p4p","definition":"Paid for Performance"},{"id":144,"acronym":"pas","definition":"Patient Assessment Survey"},{"id":146,"acronym":"pbm","definition":"Pharmacy Benefits Manager"},{"id":147,"acronym":"pcc","definition":"Primary Care Clinic"},{"id":148,"acronym":"pcp","definition":"Primary Care Physician"},{"id":149,"acronym":"pcppp","definition":"Primary Care Physician Partner Program"},{"id":150,"acronym":"pdr","definition":"Provider Dispute Resolution"},{"id":151,"acronym":"pgp","definition":"Pretty Good Privacy (encryption program)"},{"id":152,"acronym":"pharmd","definition":"Doctor of Pharmacy"},{"id":153,"acronym":"pharxm","definition":"Pharmacy Health and Prescription Management"},{"id":154,"acronym":"phcp","definition":"Priority Home Care Program"},{"id":155,"acronym":"phi","definition":"Protected Health Information"},{"id":156,"acronym":"php","definition":"Partial Hospitalization Program"},{"id":157,"acronym":"pip","definition":"Problem Intervention Plan"},{"id":159,"acronym":"polst","definition":"Physician Orders for Life-Sustaining Treatment"},{"id":160,"acronym":"pos","definition":"Place of Service"},{"id":161,"acronym":"ppe","definition":"Personal Protective Equipment"},{"id":162,"acronym":"ppg","definition":"Primary Physician Group"},{"id":163,"acronym":"prec","definition":"Payment Reconsiderations"},{"id":164,"acronym":"pu","definition":"Post Utilization"},{"id":165,"acronym":"ra","definition":" Risk Adjustment"},{"id":166,"acronym":"raf","definition":"Risk Adjustment Factor"},{"id":168,"acronym":"rn","definition":"Registered Nurse"},{"id":169,"acronym":"s4s","definition":"Strong for Surgery"},{"id":170,"acronym":"sam","definition":"System for Award Management"},{"id":171,"acronym":"sarag","definition":"Service Authorization Requests"},{"id":173,"acronym":"sdoh","definition":"Social Determinates of Health"},{"id":206,"acronym":"sds","definition":"Safety Data Sheets"},{"id":174,"acronym":"sep","definition":"Special Enrollment Period"},{"id":175,"acronym":"sm","definition":"Senior Members"},{"id":176,"acronym":"snf","definition":"Skilled Nursing Facility"},{"id":177,"acronym":"snp","definition":"Special Needs Program"},{"id":178,"acronym":"sod","definition":"Standard Organizational Determinations - also referred to as *Routine*"},{"id":179,"acronym":"soec","definition":"Seniors Only Evaluation Clinic"},{"id":180,"acronym":"srec","definition":"Standard Pre-service Reconsiderations"},{"id":181,"acronym":"ssrp","definition":"Senior Shared Risk Pool"},{"id":186,"acronym":"sw","definition":"Social Work"},{"id":187,"acronym":"tcm","definition":"Telephonic Case Management"},{"id":188,"acronym":"tof","definition":"Type of Facility"},{"id":189,"acronym":"tpl","definition":"Third Party Liability"},{"id":191,"acronym":"um","definition":"Utilization Management"},{"id":194,"acronym":"utc","definition":"Unable to Contact"},{"id":209,"acronym":"vap","definition":"Virtual Auto Post"}]