Glossary

A - B - C - D - E - F - G - H - I - J - K - L - M - N - O - P - Q - R - S - T - U - V - W - X - Y - Z

A
ADMIN	Administrative County Office
ACS	ACS State Healthcare, formerly Affiliated Computer Services, Inc., The New Mexico Medicaid Fiscal Agent.
ASC	Ambulatory Surgery Center
AVRS	Automated Voice Response System
B
BAA	Business Associate Agreement
BCBS	Blue Cross Blue Shield
BENDEX	Beneficiary and Earnings Data Exchange
BH	Behavioral Health
BHO	Behavioral Health Organization
BHPC	Behavioral Health Planning Council
BHS	Behavioral Health Services
BHSC	Behavioral Health Steering Committee
C
CDT	Current Dental Terminology
CFR	Code of Federal Regulations
CHILI	Coalition for Healthcare Leadership Initiatives
CLIA	Clinical Laboratory Improvement Act
CMS	Centers for Medicare & Medicaid Services, formerly HCFA
CMS	Children’s Medical Services - NMDOH
COE	Category of Eligibility
COLA	Cost of Living Allowance
COS	Category of Service
CPS	Child Protective Services - NM Children, Youth and Families Department
CPT	Common Procedural Terminology; Current Physician Terminology
CRT	Certified Respiratory Therapist; Certified Radiologic Technologist; Clinical Research Trial; Chemo-Radio Therapy
CSBG	Community Service Block Grant
CSED	Child Support Enforcement Division
CSMIA	Community Spouse Maintenance Income Allowance
CYFD	Children, Youth and Families Department
D
DBA	Doing Business As
D&E	Disabled and Elderly Waiver
DD	Developmental Disabilities
DHHS	Department of Health and Human Services. Federal oversight agency for CMS
DME	Durable Medical Equipment (i.e., wheelchairs, hospital beds, prosthetics)
DOB	Date of Birth
DOD	Date of Death
DOH	Department of Health
DOS	Date of Service
DRG	Diagnosis Related Group
DUR	Drug Utilization Review
E
EBT	Electronic Benefits Card
EOB	Explanation of Benefits
EOMB	Explanation of Medicare Benefits
EPSDT	Early and Periodic Screening, Diagnosis, and Treatment
F
FACTS	Family Automated Client Tracking System
FFS	Fee For Service (not under managed care)
FIT	Family, Infant, Toddler program (DOH)
FM	Federal Match code
FNS	Food and Nutrition Service
FPL	2003 Federal Poverty Level Guidelines (except Alaska, Hawaii, and D.C.)
FPS	Family Planning Services
FPW	Family Planning Waiver
FQHC	Federally Qualified Health Center
G
GEO	Geographical County
H
HCBW	Home & Community Based Waivers
HCFA	Health Care Financing Administration, now CMS
HCPCS	Healthcare Common Procedure Coding System
HIPAA	Health Insurance Portability and Accountability Act of 1996
HSD	Human Services Department
I
ICF	Intermediate Care Facility
ICF-MR	Intermediate Care Facility for the Mentally Retarded
IEP	Individual Education Plan
IHS	Indian Health Services
ISD	Income Support Division
ISD2	Income Support Division Integrated Service Delivery System
ISP	Individual Service Plan
J
No entries
K
No entries
L
LIHEAP	Low Income Home Energy Assistance Program
LTC	Long Term Care
M
MAC	Maximum Allowable Cost or Medicaid Advisory Committee
MAD	Medical Assistance Division
MAWC	Medical Assistance for Women and Children
MCO	Managed Care Organization
MEVS	Medicaid Eligibility Verification System
MF	Medically Fragile
MITS	Medicaid in the Schools (now called MSBS; fee-for-service program)
MMIS	Medicaid Management Information System
MSBS	Medicaid School-Based Services (formerly MITS; fee-for-service program)
N
NF	Nursing Facility
NMAC	New Mexico Administrative Code
NMWorks	New Mexico Works Program for cash assistance (also known as TANF)
NPP	Notice of Privacy Practices
O
OASDI	Old Age, Survivors, and Disability Insurance (federal)
OCR	Office of Civil Rights
Omnicaid	NM Medicaid Management Information System (MMIS)
P
PA	Prior Authorization
PACE	Program of All-Inclusive Care for the Elderly (long term care outpatient program)
PCN	Primary Care Network
PCO	Personal Care Option
PDCS	Prescription Drug Claim System
POS	Point of Sale/Service
PPS	Provider Payment System (DOH)
PTOT	Physical Therapy/Occupational Therapy
Q
QD	Qualified Disabled Working Individual
QMB	Qualified Medicare Beneficiary
R
RA	Remittance Advice (for providers)
REOMB	Recipient Explanation Of Medical Benefits
RHC	Rural Health Center
RHI	Retiree Health Insurance
RTC	Residential Treatment Center
S
Salud!	NM Medicaid Managed Care Program
SBHC	School-Based Health Center/MCO Pilot Project
SCHIP	State Children's Health Insurance Program
SCI	State Coverage Initiative
SDX	State Data Exchange
SLIMB	Specified Low Income Medicare Beneficiary
SNF	Skilled Nursing Facility
SSA	Social Security Administration - Medicare Benefits
SSI	Supplemental Security Income - Medicaid Benefits
SSN	Social Security Number
STD	Sexually Transmitted Disease
SURS	Surveillance and Utilization Review System
T
TANF	Temporary Assistance for Needy Families (cash assistance program)
TBI	Traumatic Brain Injury
TCM	Targeted Case Management
TCN	Transaction Control Number (usually the same as the claim number)
TPA	Trading Partner Agreement (for providers who submit electronic claims)
TPL	Third Party Liability (insurance coverage other than Medicaid)
U
UR	Utilization Review
V
No entries
W
WDI	Working Disabled Individual Program
X
No entries
Y
No entries
Z
No entries