One thing I find very confusing, when dealing with reimbursement and practice management issues, is the use of acronyms. There are so many of them!! I like to keep a list of them handy, so I can update and refer to them as needed. This is my current list. I will use these acronyms in future posts, and I will try to elaborate on them as appropriate. Hopefully, you will find this list useful.
A
ABN – Advanced Beneficiary Notice
ACA – Affordable Care Act, also called PPACA (Patient Protection and Affordable Care Act)
ACO – Accountable Care Organization
ALOS – Average Length of Stay
APC – Ambulatory Payment Classification
APMs – Alternative Payment Models
B
C
CARE Bill – Consistency, Accuracy, Responsibility and Excellence
CCI – Correct Coding Initiative
CDM – Charge Description Master files
CHIP – Children’s Health Insurance Program
CMMI – Center for Medicare and Medicaid Innovation
CMS – Centers for Medicare & Medicaid Services
CPT – Current Procedural Terminology
CQI – Continuous Quality Improvement
D
DRG – Diagnosis Related Group
E
EHR/EMR – Electronic Health Record / Electronic Medical Record
EOB – Explanation of Benefits
EOC – Episode of Care
F
FFS – Fee for Service
G
GAO – General Accountability Office
GI – Geographic Index
GPCI – Geographic Practice Cost Index
H
HBP – Hospital Based Physician
HCPCS – Healthcare Common Procedure Coding System
HHS – Department of Health and Human Services
HIPAA – Health Insurance Portability and Accountability Act
HIO – Health Information Organization
HISP – Health Information Service Provider
HOPPS – Hospital Patient Prospective Payment System
I
IDN – Integrated Delivery Network
IDS – Integrated Delivery System
IPAB – Independent Payment Advisory Board
J
JCAHO – Joint Commission for Accreditation of Health Organizations
K
L
LCD – Local Coverage Determination
LMRP – Local Medical Review Policy
M
MAC – Medicare Administrative Contracts
MACRA – Medicare Access & CHIP Reauthorization Act of 2015
MCD – Medicare Coverage Database
MCO – Managed Care Organization
MedPAC – Medicare Payment Advisory Organization
MIPS – Merit-Based Incentive Payment System
MSSP – Medicare Shared Savings Program
N
NCD – National Coverage Determination
NCHS – National Center for Health Statistics
NDPS – National Drug Pricing System
NPDB – National Practitioner Data Bank
NPI – National Provider Identifier
O
P
PAG – Policy Advisory Group
PEPP – Payment Error Prevention Program
PFFS – Private Fee-for-Service
PFS – Physician Fee Schedule
PFMs – Physician-Focused Payment Models
PIM – Program Integrity Model
PORS – Provider Overpayment Recovery System
PPO – Preferred Provider Organization
PPR – Prospective Payment Review
PQRS – Physician Quality Reporting System
PSRO – Physician Service Review Organization
PTAC – Physician-Focused Payment Model Technical Advisory Committee
PTAN – Provider Transaction Access Number
Q
QPP – Quality Payment Program
R
RAC – Reimbursement Advisory Committee
RADARS – Ranking & Data Analysis Reporting System
RBRVS – Resource-Based Relative Value Scale
RUGs – Resource Utilization Groups
RVC/RUC – AMA/Specialty Society Relative Value Scale Update Committee
RVU – Relative Value Unit
S
SAAAVE – Screening Abdominal Aortic Aneurysms Very Efficiently
T
TIN – Taxpayer Identification Number
U
V
W
X
Y
Z