|
|
| AA |
Administrative Assistant |
| AAHC |
American Accreditation Healthcare Commission/URAC |
| ABC |
Abridged Benefits of CHAMPUS |
| ABSR |
Assistant Beneficiary Service Representative |
| ACD |
Automatic Call Distribution |
| ACM |
Area Coordination Meeting |
| ACO |
Administrative Contracting Officer |
| ACOR |
Alternate Contracting Officer’s Representative |
| ACP |
American College of Physicians |
| AD |
Active Duty |
| ADA |
Americans with Disabilities Act |
| ADAMHA |
Alcohol, Drug Abuse and Mental Health Administration |
| ADD |
Active Duty Dependent |
| ADFM |
Active Duty Family Member |
| ADP |
Automated Data Processing |
| ADSM |
Active Duty Service Member |
| AEP |
Appropriateness Evaluation Protocol |
| AFB |
Air Force Base |
| AFDC |
Aid to Families with Dependent Children |
| AFPC |
Armed Forces Policy Council |
| AH |
Army Hospital |
| AHA |
American Hospital Association |
| AHP |
Accountable Health Plan |
| AIP |
Analysis Improvement Plan |
| AIS |
Automated Information Systems |
| ALGS |
Automatic Letter Generating System |
| ALOS |
Average Length Of Stay |
| AM&S |
Office of Acquisition and Management Support |
| AMA |
Against Medical Advice OR American Medical Association |
| AMC |
Army Medical Center |
| AMD |
Associate Medical Director |
| ARU |
Automated Response Unit |
| ASC |
Ambulatory Surgical Centers |
| ASD(HA) |
Assistant Secretary of Defense for Health Affairs |
| ASO |
Administrative Services Only |
| AVR |
Automated Voice Response |
| AWP |
Average Wholesale Price |
| |
|
| BAFO |
Best and Final Offer (Replaced by FPR) |
| BBP |
Blood Borne Pathogens |
| BCAC |
Beneficiary Counseling Assistance Coordinator |
| BCBSSC |
Blue Cross and Blue Shield of South Carolina |
| BES |
Best Estimate Submission |
| BIS |
Beneficiary Information System |
| BPA |
Bid Price Adjustment |
| BRAC |
Base Realignment And Closure |
| BSR |
Beneficiary Services Representative |
| BUMED |
Bureau of Medicine |
|
|
| C&CS |
Office of Communications and Customer Service |
| CACI |
Marketing and Education Contractor |
| CAM |
Catchment Area Management |
| CAP |
Corrective Action Plan |
| CATCAP |
Catastrophic Cap |
| CBC |
Construction Battalion Center (Navy) |
| CBHP |
Choice Behavioral Health Partnership |
| CBSR |
Centralized Beneficiary Service Representative |
| CCDD |
Catastrophic Cap and Deductible Database |
| CCHI |
Center for Corporate Health, Inc. |
| CCS |
Crippled Children’s Services |
| CEBO |
Central Enrollment and Billings Office |
| CEIS |
Corporate Executive Information System |
| CEO |
Chief Executive Officer |
| CF |
Conversion Factor |
| CHAMPUS |
Civilian Health and Medical Program of the Uniformed Service |
| CHAMPVA |
Civilian Health and Medical Program of the Veterans Administration |
| CHAP |
Community Health Accreditation Program |
| CHCBP |
Continued Health Care Benefits Program |
| CHCS |
Composite Health Care System |
| CHIN |
Community Healthcare Information Network |
| CIA |
Corporate Integrity Agreement |
| CIS |
Clinical Intake Specialist |
| CLO |
Contract Liaison Officer |
| CM |
Case Management |
| CMMS |
Claims Medical Management System
(formerly CHAMPUS Regional Intermediary System or CRIS) |
| CMN |
Certificate of Medical Necessity |
| CMS |
Contact Management System OR Center for Medicare and Medicaid Services |
| COB |
Coordination of Benefits |
| COBRA |
Consolidated Omnibus Budget Reconciliation Act |
| COE |
Center of Excellence |
| CON/CN |
Certificate of Need |
| COO |
Chief Operating Officer |
| CONUS |
Continental United States |
| COR |
Contracting Officers Representative |
| CPR |
Chronological Patient Record |
| CPS |
Clinical Preventive Services |
| CPT-4 |
Current Procedural Terminology 4th edition |
| CPU |
Central Processing Unit |
| CQMP |
Clinical Quality Management Program |
| CRIS |
CHAMPUS Regional Intermediary System (now known as CHAMPUS Medical Management System) |
| CRT |
Cathode Ray Tube |
| CTI |
Computer Telephone Interface |
| CWF |
Common Working File |
| CY |
Calendar Year |
|
|
| DCAA |
Defense Contracting Audit Agency |
| DCAO |
Debt Collection Assistance Officer |
| DCP |
Data Collection Period |
| DD2161 |
Department of Defense Form 2161 (for referrals) |
| DEERS |
Defense Enrollment Eligibility Reporting System |
| DEPSECDEF |
Deputy Secretary of Defense |
| DG |
Defense Guidance |
| DHHS |
Department of Health and Human Services |
| DHP |
Defense Health Program |
| DITSCAP |
DoD Information Technology Security Certification and Accreditation Process |
| DM |
Disease Management |
| DMCA |
Defense Management Contracting Agency |
| DMDC |
Defense Manpower Data Center |
| DME |
Durable Medical Equipment |
| DMERC |
Durable Medical Equipment Regional Carrier |
| DMIS |
Defense Medical Information System |
| DMPA |
Defense Medical Programs Activity |
| DNA |
Dynamic New Alliance |
| DO |
Doctor of Osteopathy |
| DoD |
Department of Defense |
| DOES |
Defense Online Enrollment System |
| DRB |
Defense Resources Board |
| DRG |
Diagnosis Related Groups |
| DSO |
DEERS Support Office |
| DTF |
Dental Treatment Facilities OR Designated Treatment Facilities |
| DUR |
Drug Utilization Review |
| DVA |
Department of Veterans Affairs |
|
|
| E/M |
Evaluation of Management Services (Codes), CPT Codes |
| EBC |
Enrollment Based Capitation |
| ECHO |
Extended Care Home System |
| ECS |
Electronic Claims Submission |
| ECT |
Electronic Claims Transmission |
| EFMP |
Exceptional Family Member Program |
| EFT |
Electronic Funds Transfer |
| EHHC |
ECHO Home Health Care |
| EHP |
Employee Health Program |
| EIN |
Employer Identification Number |
| EMC |
Electronic Media Claims (paperless Claims Processing) |
| EOB, EOMB |
Explanation of (Medicare or Medical) Benefits |
| EOC |
Explanation of Check |
| ERISA |
Employee Retirement Insurance Security Act |
| ESRD |
End Stage Renal Disease |
| EWRAS |
Enterprise Wide Referral and Authorization System |
|
|
| FAMS |
Fraud and Abuse Management System |
| FAR |
Federal Acquisition Regulation |
| FASB |
Federal Accounting Standards Board |
| FEHBP |
Federal Employee Health Benefit Plan |
| FEP |
Federal Employee Program |
| FFS |
Fee-For-Service |
| FI |
Fiscal Intermediary |
| FOIA |
Freedom of Information Act |
| FOIO |
Freedom of Information Office |
| FPR |
Final Proposal Revision (replaces BAFO – Best and Final Offer) |
| FRC |
Federal Records Center |
| FTE |
Full-Time Equivalent |
| FY |
Fiscal Year |
|
|
| GAAP |
Generally Accepted Accounting Principles |
| GAO |
General Accounting Office |
| GHAA |
Group Health Association of America |
| GIQD |
General Inquiry DEERS |
| GPCI |
Geographic Practice Cost Index |
| GSUS |
Geographically Separated Units 50 miles outside of MTFs |
|
|
| HAL |
Health Awareness Letter |
| HBA |
Health Benefits Advisor |
| HCF |
Health Care Finder |
| HCFA |
Health Care Financing Administration |
| HCFA-1500 |
Health Care Finance Administration Claim Form |
| HCPCS |
HCFA Common Procedure Coding System |
| HCSR |
Health Care Service Record |
| HEDIS |
Healthplan Employer Data and Information Systems |
| HHA |
Home Health Agency OR Home Health Aide |
| HHC |
Home Health Care |
| HHS |
Health and Human Service |
| HINN |
Hospital Issued Notices on Non-Coverage |
| HIPAA |
Health Insurance Portability and Accountability Act of 1996 |
| HMHS |
Humana Military Healthcare Services |
| HMO |
Health Maintenance Organization |
| HMSI |
Health Management Strategies International |
| HPA&E |
Office of Health Program Analysis and Evaluation |
| HRA |
Health Risk Appraisal |
| HVHS |
Humana Veterans Healthcare Services |
|
|
| ICD-9CM |
International Classification of Diseases, Volume 9 Clinical Modification |
| ICN |
Internal Control Number (Claims) |
| IEP |
Individualized Educational Program |
| IIHI |
Individual Identifiable Health Information |
| IM/IT |
Information Management/Information Technology |
| IP |
Inpatient |
| IPA |
Individual Practice Association |
| IPS |
Individual Pricing Summary |
| IPT |
Integrated Process Team |
| IVR |
Interactive Voice Response |
|
|
| JCAHO |
Joint Commission on Accreditation of Healthcare Organizations |
| JCS |
Joint Chiefs of Staff |
| JIEP |
Joint Intelligence Estimate for Planning |
| JPAM |
Joint Program Assessment Memorandum |
|
|
| KO |
Contracting Officer |
| KOI |
Key Operational Indicators |
|
|
| LA |
Lead Agent |
| LAN |
Local Area Network |
| LCSW |
Licensed Clinical Social Worker |
| LMHC |
Licensed Mental Health Counselor |
| LOA |
Leave of Absence |
| LOI |
Letter of Intent |
| LOS |
Length of Stay |
| LPC |
Licensed Professional Counselor |
| LPN |
Licensed Practical Nurse |
| LTAC |
Long Term Acute Care |
| LTC |
Long Term Care |
| LVN |
Licensed Vocational Nurse |
|
|
| MBO |
Management by Objectives |
| MCAS |
Marine Corps Air Station |
| MCB |
Marine Corps Base |
| MCS |
Managed Care Support |
| MCSC |
Managed Care Support Contractor |
| MD |
Doctorate of Medicine |
| MDC |
Major Diagnostic Categories |
| MFE |
Multi-faceted Evaluation |
| MFS |
Medicare Fee Schedule |
| MHSO |
Office of Military Health Systems Operations |
| MHS |
Military Health System |
| MHSS |
Military Health Services System |
| MLR |
Medical Loss Ratio |
| MMSO |
Office of Military Health Systems Operations |
| MOD |
Modification |
| MOH |
Medal of Honor |
| MOU |
Memorandum of Understanding |
| MPS |
Managed Prescription Services |
| MSR |
Medical Service Review |
| MTF |
Military Treatment Facility |
|
|
| NADD |
Non-Active Duty Dependent |
| NADFM |
Non-Active Duty Family Member |
| NAS |
Non-Availability Statement |
| NATO |
North Atlantic Treaty Organization |
| NCQA |
National Council for Quality Assurance |
| NDAA |
National Defense Authorization Act |
| NDC |
National Drug Code |
| NDMS |
National Disaster Medical System |
| NEC |
Not Elsewhere Classified (ICD-9CM code) |
| NED |
National Enrollment Database |
| NH |
Naval Hospital |
| NICU |
Neonatal Intensive Care Unit |
| NMC |
Naval Medical Center |
| NMFA |
National Military Families Association |
| NMHCC |
National Managed Health Care Congress |
| NNW |
Non-Network |
| NOAA |
National Oceanic and Atmospheric Administration |
| NOS |
Not Otherwise Specific (ICD-9CM code) |
| NPDB |
National Practitioner Data Bank |
| NPI |
National Provider Identifier |
| NQMC |
National Quality Monitoring Contractor |
| NSC |
National Security Council |
| NW |
Network |
|
|
| OASD(HA) |
Office of the Assistant Secretary of Defense (Health Affairs) |
| OCONUS |
Outside the Continental United States |
| OCR |
Optical Character Recognition |
| OGP |
Other Government Programs |
| OHI |
Other Health Insurance |
| OLA |
Office of the Lead Agent |
| OOA |
Out of Area |
| OPI |
CHAMPUS Office of Program Integrity |
| OPM |
Operations Procedures Manual |
| OSD |
Office of the Secretary of Defense |
| OSHA |
Occupational Safety and Health Administration |
| OTR |
Outpatient Treatment Report |
|
|
| PACU |
Post Anesthesia Care Unit |
| Part A |
Medicare Part A |
| Part B |
Medicare Part B |
| PAS |
Patient Appointing Services |
| PAT |
Pre-Admission Testing OR Performance Assessment Tool |
| PCC |
Patient Care Coordinator |
| PCM |
Primary Care Manager |
| PCMBN |
Primary Care Manager by Name |
| PCO |
Procuring Contracting Officer |
| PCP |
Primary Care Provider |
| PDM |
Program Decision Memorandum |
| PDMS |
Provider Data Management System |
| PERR |
Provider Education/Relations Representative (See also PR) |
| PFPWD |
Program for Persons with Disabilities (replaced by ECHO – Extended Health Care Option) |
| PGBA |
Palmetto Government Benefits Administrators |
| PhD |
Doctorate of Philosophy |
| PHI |
Protected Health Information (individually identifiable) |
| PHP |
Psychiatric Partial Hospitalization Programs |
| PI |
Program Integrity |
| PIA |
Procurement Integrity Act |
| PIN |
Provider Identification Number |
| PIO |
Procurement Integrity Officer |
| PIP |
Periodic Interim Payment |
| PMPM |
Per Member Per Month |
| POC |
Place of Care |
| POD |
Physician Organized Delivery System |
| PODS |
Processing Operations and Dedicated Services (PGBA/Claims) |
| POM |
Program Objectives Memorandum |
| POS |
Point of Service |
| POT |
Place of Treatment OR Plan of Treatment |
| PPBES |
Planning, Programming, Budgeting, and Execution System |
| PPO |
Preferred Provider Organization |
| PQI |
Potential Quality Indicator |
| PRAF |
Patient Referral Authorization Form |
| PRO |
Peer Review Organization |
| PR |
Provider Representative (See also PERR) |
| PSDA |
Patient Self Determination Act |
| PSRO |
Professional Standards Review Organization |
|
|
| QA |
Quality Assurance (synonymous with Quality Management) |
| QIT |
Quality Improvement Team |
| QM |
Quality Management |
|
|
| RACO |
Regional Area Contracting Officer |
| RBRVS |
Resource Based Relative Value System (Scale) |
| RC |
Reserve Component |
| REA |
Request for Equitable Adjustment |
| RFP |
Request for Proposal |
| RM |
Office of Resource Management |
| RMD |
Regional Medical Director |
| RO |
Regional Office |
| ROM |
Rough Order of Management |
| ROPO |
Report of Performance Observation |
| ROR |
Right of Refusal |
| RRA |
Regional Review Authority |
| RRB |
Railroad Retirement Board |
| RTC |
Residential Treatment Centers |
| RVS |
Relative Value Study (Schedule or Scales) |
| RVU |
Relative Value Unit Services |
|
|
| SHCP |
Supplemental Health Care Program |
| SNF |
Skilled Nursing Facility |
| SO |
Second Opinion |
| SPOC |
Service Point of Contact |
| SSAC |
Source Selection Advisory Council |
| SSEB |
Source Selection and Evaluation Board |
| SSI |
Supplemental Security Income |
| SSN |
Social Security Number |
| STAR FORCE |
Skilled, Trained and Ready - Focused on Reserve Components, Enhanced |
| STSF |
Specialized Treatment Service Facility |
| STS |
Specialized Treatment Services |
| SUDRF |
Substance Use Disorder Rehabilitation Facility (SUDRF) |
|
|
| TAC |
TRICARE Allowable Charge |
| TAMP |
Transitional Assistance Management Program |
| TDEFIC |
TRICARE Dual Eligible Fiscal Intermediary Contract |
| TDP |
TRICARE Dental Program |
| TED |
TRICARE Encounter Data |
| TEFRA |
Tax Equity and Fiscal Responsibility Act |
| TEOB |
TRICARE Explanation of Benefits (Formerly CEOB) |
| TFL |
TRICARE for Life |
| TIN |
Tax Identification Number |
| TITLE 10 |
CHAMPUS |
| TITLE 18 |
Medicare |
| TITLE 19 |
Medicaid |
| TITLE 5 |
Maternal and Child Health |
| TITLE I |
Hill Burton |
| TMA |
TRICARE Management Activity (formerly called OCHAMPUS) |
| TMAC |
TRICARE Maximum Allowable Charge |
| TMCS |
Total Managed Care System |
| TMOP |
TRICARE Mail Order Pharmacy |
| TOM |
TRICARE Operations Manual |
| TOPS |
TRICARE Operational Performance Standards |
| TOS |
Type of Service |
| TPC |
Third Party Collections |
| TPL |
Third Party Liability |
| TPM |
TRICARE Policy Manual |
| TPO |
Treatment, Payment and Operations |
| TPR |
TRICARE Prime Remote |
| TPRADFM |
TRICARE Prime Remote Active Duty Family Member |
| TRAC |
TRICARE Regional Advisory Committee |
| TRIDDE |
TRICARE Direct Data Entry |
| TRM |
TRICARE Reimbursement Manual |
| TRO |
TRICARE Regional Office |
| TROS |
TRICARE Regional Office South |
| TRS |
TRICARE Reserve Select |
| TRSDP |
TRICARE Selected Reserve Dental Program |
| TSC |
TRICARE Service Center |
| TSO |
TRICARE Support Office |
| |
|
| UB-92 |
Uniform Billing form – 1992 |
| UCR |
Usual, Customary, and Reasonable |
| UHDDS |
Uniform Hospital Discharge Data Set |
| UIC |
Unit Identification Code |
| UM |
Utilization Management |
| UPIN |
Universal (Unique) Physician Identification Number |
| UR |
Utilization Review |
| URAC |
Utilization Review Advisory Committee(See AAHC) |
| USA |
United States Army |
| USAF |
United States Air Force |
| USCC |
Unified and Specified Combatant Commands |
| USCG |
United States Coast Guard |
| USFHP |
Uniformed Services Family Health Plan |
| USMC |
United States Marine Corps |
| USN |
United States Navy |
| USPHS |
U.S. Public Health Service |
| USTF |
Uniformed Services Treatment Facility |
| USUHS |
Uniformed Services University of the Health Sciences |
|
|
| VA |
Veterans Administration/Affairs |
| VIP |
Voluntary Insurance Plan |
| VRU |
Voice Response Unit |
|
|
| WC |
Worker's Compensation |
| WHO |
World Health Organization |
| WPA |
Written Prior Authorization |
| WPS |
Wisconsin Physicians Service |
