DOCUMENT
Oregon Medicaid Management Information System (MMIS) Glossary
943 definitions by The State of Oregon

Abandoned CallAccelerated Submission and Processing (ASAP)Access Control Facility (ACF2)Access Control Facility/Multiple Virtual Storage (ACF/MVS)Accidental Death and Dismemberment BenefitAccommodationAccommodation ChargeAccounts Receivables (AR, A/R)AccretionActual ChargeAd Hoc RequestAdjudicate (CLAIM)Adjudication CycleAdjusted ClaimAdjusted Clinical Groups (ACG)Adjustment (ADJ)Adjustment Analyst IDAdjustment ProcessingAdjustment Reason Codes (Primary and Secondary)AdministrativeAdministrative FeeAdministrative Reconsideration (AR)Administrative Review (AR)Administrative Service Organization (ASO)Administrative Services (AS)Administrative UserAdmissionAdult Care Home (ACH)Advanced Registered Nurse Practitioner (ARNP)Advance Planning Document (APD)AggregateAggregation CodeAid CategoryAid CodeAid to Families with Dependent Children (AFDC)AlertsAllergy Group Code Cross Sensitive (AGCCS)Allergy Group Code Specific (AGCSP)Allowable CostsAllowed AmountAlphanumericAmerican Dental Association (ADA)American Medical Association (AMA)American National Standards Institute (ANSI)American Standard Code for Information Interchange (ASCII)Ancillary ChargeAppealAppellantApplicantApplication Tracking Number (ATN)ArchiveArea Agency on Aging (AAA)As of DateAssigned ClaimAssignmentAssignment PlanAttachmentAttributeAttributeAuditAudit Adjustment (AUD)AuthenticationAuthorization TestingAuto AssignmentAutomated Information System (AIS)Automated Voice Response System (AVRS)Automatic RecoupmentAverage Manufacturer Price (AMP)Average Wholesale Price (AWP)BackupBalanced Budget Act of 1997 (BBA)BatchBatch CycleBatch ProcessingBatch RequestBeneficiaryBeneficiary and Earnings Data Exchange (BENDEX)Beneficiary Billed ClaimBeneficiary Data SheetBeneficiary Master FileBenefit PeriodBenefit PlanBenefit Plan HierarchyBenefitsBest PriceBillBillable HourBilled AmountBilling CycleBilling ProviderBitmapBlue Cross and Blue Shield (BC/BS)Brand (or Trade) NameBrightnessBulletinsBundled ChargesBundled SaleBusiness DayBusiness ObjectsBusiness ProcessesBuy-InBuy-In Data MaintenanceBuy-In (Medicaid)ByteCacheCallCapability Maturity Model Integration (CMMI)CapitationCapitation RateCapitation Service (Capitation Ser)CaptivaCarrierCarve Out DrugsCase GroupCase HeadCase Management/ManagerCase Mix IndexCase NumberCase TypeCash Control Number (CCN)Cash Receipt (CR)Categorically NeedyCategory of Service (Cat of Srvc, Cos)Center for Enabling Client Excellence (CECE)Center for Independent Living (CIL)Centers for Medicare and Medicaid Services (CMS)Central Processing Unity (CPU)Certificate of Creditable CoverageCertificationCertification DateCFP ContractorsChange ControlChange Control Board (CCB)Change Control Process (CCP)Change Control Request (CCR)Change Order (CO)Change System Request (CSR)Character RecognitionCharacter ValidationChildren, Adults, and Families (CAF)Civilian Health and Medical Programs of the Uniformed Services (CHAMPUS)ClaimClaim AdjustmentClaim Detail NumberClaim DispositionClaim HistoryClaim LocationClaim PricingClaim Processing (CP)Claims CycleClaims EngineClaims History FileClaim TypeClass of ServiceClean ClaimClerk IDClientClient, Assessment, Referral and Community-Based System (CARE/HCBS)Client Maintenance System (CMS)Client ObligationClinical Laboratory Improvement Amendments (CLIA)Closed FormularyCMSCode of Federal Regulations (CFR)CohortCoinsuranceCommon Business-Oriented Language (COBOL)Common Gateway Interface (CGI)Common Procedural Terminology (CPT)Communication ProtocolCommunicationsCommunication SoftwareCommunity Based ScreeningCommunity Developmental Disability Organization (CDDO)Community Mental Health Center (CMHC)Compact Disk (CD)Compact Disk-Read Only Memory (CD-ROM)CompendiumComplaintCompliance CheckingComputer Output to Laser Disk (COLD)Computing and Networking Infrastructure Consolidation (CNIC)Configuration ManagementConfirmation NumberConsolidation of Benefits in Retirement Act (COBRA)Consultation TimeConsultative Committee on International Telegraph and Telephone (CCITT)Consumer Explanation of Benefits LetterConsumer Price Index (CPI)ContactContact TrackingContact Tracking Number (CTN)ContractingContractorContract RatesContract Start DateControlled Drugs / Scheduled DrugsConversion FactorCoordination of Benefits (COB)Copay/CopaymentCorporate DocumentsCorrespondenceCost AvoidanceCost SharingCountersCoverage CodeCoverage RulesCPTCredit (CR)Crossover ClaimCross-WalkCurrent Procedural Terminology, Fourth Edition (CPT-4)CursorCustomary ChargeCutbackCycleData AccessibilityDatabase Administrator (DBA)Database (DB)Data CorrectionData Element Dictionary (DED)Data EntryData Interchange Standards Association (DISA)DatamartData WarehouseDate of Adjudication (DOA)Date of Payment (DOP)Date of Receipt (DOR)Date of Service (DOS)DebitDecision Support Surveillance and Utilization Review (DSSUR)Decision Support Surveillance and Utilization Review System (DSSURS)DecompressDeductibleDefaultDefense Enrollment and Eligibility Reporting System (DEERS)DelimiterDenied ClaimDenyDepartment of Human Services (DHS)Desktop Imaging SystemDetail (DTL)Detailed Implementation Schedule (DIS)Detailed System Design (DSD)Detail NumberDiagnosis Code (DIAG, DX)Diagnosis-Related Group (DRG)Diagnostic and Statistical Manual for Mental Disorders, Third Edition, Revised (DSM III)Direct PriceDisabilityDisability BenefitDisability Income InsuranceDisaster Recovery (DR)DisenrollmentDispensing FeeDispositionDisproportionate Share Hospital (DSH)DoctorDocumentDocument Control Number (DCN)Document ImagesDocument RetrievalDoing Business As (DBA)Dosage Range Check Module (DRCM)DownloadDRGDrilldownDrop Down Datawindow (DDDW)DrugDrug Efficacy Study Implementation Program (DESI)Drug Enforcement Agency (DEA)Drug FormularyDrug Rebate System (DR, Drs)Drug to Drug Interactions (DDI)Drug Utilization Review (DUR)Drug WholesalerDssmeasurebaseDssnavigatorDssprofilerDual EligibleDuplicate PaymentDurable Medical Equipment (DME)DXEarly and Periodic Screening, Diagnosis, and Treatment (EPSDT)Early Refill (ER)EDI Sumbitter/SenderEditEDS Dur+EDS United States Government Solutions (USGS)eFormElectonic Claims Management (ECM)Electronic Benefits Transfer (EBT)Electronic Data Interchange (EDI)Electronic Data Systems (EDS)Electronic Document Management System (EDMS)Electronic Eligibility Verification System (EEVS)Electronic Funds Transfer (EFT)Electronic Media Claims (EMC)Electronic Remittance Advice (ERA)Electronic Remittance Notice (ERN)Eligibility FileEligibleEligible ProviderEmbedded Sequence Number (ESN)EncounterEncounter (Adjucated)Encounter AdjustmentEncounter DataEncounter Paid StatusEncounter RateEnrolledEnrolleeEnrollment ApplicationEnvelopeEpisode Treatment Grouper (ETG)Estimated Acquisition Cost (EAC)ETLEvaluation IntervalEvent Detail TableEvent Inhibit String (EIS)ExceptionException CodeExchange CodeExecutive Information System (EIS/DSS)Expenditures (EXP)Explanation of Benefits (EOB)Explanation of Medical Benefits (EOMB)Extended Care Facilities (ECF)Extensible Markup Language (XML)External Quality Review Organization (EQRO)Fair Hearing (Ancillary Application)Fair Hearing (FH)Fair, Issaac’s WebstationFamily Planning (FP)Federal Employer Identification Number (FEIN)Federal Financial Participation (FFP)Federal Fiscal Year (FFY)Federal Information Processing Standards (FIPS)Federal Insurance Contributions Act (FICA)Federally Qualified Health Center (FQHC)Federal Medical Assistance Percentage (FMAP)Federal Poverty Level (FPL)Federal Register (FR)Federal Systems Electronic Commerce (FSEC)Federal Upper Limit Costs (FUL, FULC)Fed Fiscal YearFee-For-Service (Adjudicated)Fee-For-Service (FFS)Fee-For-Service StatusFee ScheduleFieldField Level ParametersField ValidationFile Allocation Table (FAT)File MaintenanceFile Transfer Protocol/Program (FTP)Finance and Policy Analysis (FPA)FirewallFiscal Agent (FA)Fiscal Intermediary (FI)Fiscal Year (FY)Flat FileFocused Medical Reivew (FMR)FoldersFood and Drug Administration (Federal Drug Agency, FDA)Food Stamps (FS)Forcing EditForm Level ParametersFormularyFoster Care (FC)Frail Elderly Waiver (FE)Fraud and Abuse Detection System (FADS)Fraud and Abuse (F&A)Freedom of Information Act (FOIA)From Date of Service (FDOS)Full Text SearchFunctional AcknowledgementGarnishmentGatewayGeneral PractitionerGenericGeneric Code Nubmer Sequence Number (GCN SEQ NO)Generic Code Number (GCN)Generic Price Indentifier (GPI)Global Positioning Software (GPS)Global Solutions Management System (GSMS)Graphical User Interface (GUI)GraphicsGray ScaleGrievance/ComplaintGross AdjustmentGroup PracticeGSHard DiskHCFA-1500HCFA 64.9 ReportHeader (HDR)Head Injured Rehabilitation Facility (HIRF)Head Injury Waiver (HI)Health and Human Services (HHS)Healthcare Analysis (HCA)Healthcare Common Procedure Coding System (HCPCS)Healthcare Common Procedure Coding System (HCPCS)Health Care Policy/Medical Policy (HCPMP)Health InsuranceHealth Insurance Beneficiary Number (HIB)Health Insurance Portability and Accoutability Act of 1996 (HIPAA)Health Insurance Premium Payment System (HIPP)Health Maintenance Organization (HMO)Health Management Systems (HMS)Health PlanHealth Plan Employer Data and Information Set (HEDIS)Health Plan Employer Data and Information Set Standard (HEDIS Standard)Health Services Commission (HSC)HearingHelp DeskHeritage Information SystemsHIC4Hierarchical File System (HFS)Hierarchical Ingredient Code (HIC)Hierarchical Ingredient Code List (HICL Number)HighlightHigh ResolutionHighviewHistory OffHNC SoftwareHome and Community Based Services (HCBS)Home Care Review (HCR)Home Health Agency (HHA)HospiceHospitalHospital Insurance Program (PART A)HostHot KeyHot RedundancyHsc FilesHsc ListHypertext Markup Language (HTML)Hypertext Transfer Protocol Secure (HTTPS)Hypertext Transfer Protol (HTTP)IconImageImage CaptureImage Character Recognition (ICR)Image Locator Number (ILN)Image ResolutionImagingImaging SystemImplementation GuideImpromptuIncident Number (INC NO)Independent Living Counselor (ILC)Individual Beneficiary Eligibility StatusIndividual State AgreementIndustry SpecificInformation Management System (IMS)Information Services (IS)Information Technology (IT)Information Technology (IT)Ingrediant Duplication (ID)Initiating Clerk IdInpatient (IN, INP, IP)InquiryInspection of Care (IOC)Institution for Mental Disease (IMD)InsuranceIntegrated Information System (IIS)Integrated Test Facility (ITF)Intensive Care Unit (ICU)InteractiveInteractive RequestInteractive Voice Response (IVR)InterchangeIntermediaryIntermediate Care Facility for Mental Retardation (ICF/MR)Intermediate Care Facility (ICF)Internal Control Number (ICN)Internal Control Number (ICN)International Classification of Diseases (ICD)International Classification of Diseases, Ninth Revision (ICD-9-CM)International Standards Organization (ISO)Internet Control Message Protocol (ICMP)Internet Protocol (IP)Internet Service Provider (ISP)Invitation to Bid (ITB)InvoiceInvoice TypesIssueJcodeJob Control Language (JCL)Job QueueJoinJoin PathsJukeboxJulian DateJuvenile Justice Information System (JJIS)KeyKey ProceduresKilobyteKODAK 990DLabelerLaser DiscLate Refill (LR)Legend DrugsLength of Stay/Service (LOS)Leveraged Technology Group (LTG)LiaisonLifetime History FileLifetime Reserve DaysLine ItemLine NumberLiving Arrangement Code (LAC)Local Area Network (LAN)Local CodesLock-InLock OutLong Term Care Facility (LTCF)Long Term Care (LTC)Lost WarrantLow Income Energy Assistance Program (LIEAP)Magnetic Disk and TapeMagnetic Resonance Imaging (MRI)MainframeManaged Care (MC)Managed Care Organization (MCO)Managed Care PlanManaged Care Representatives (MCR)Managed Care Supplemental Delivery PaymentManaged Care Team (MCT)Management Administrative Reporting Subsystem (MAR, MARS)Manual ChecksManual ClaimsManual RecoupmentsMapinfoMappingMass AdjustmentsMaximum Allowable Charge/Cost (MAC)Maximum ConcurrentMedia TypeMedicaidMedicaid Change Request (MCR)Medicaid HIPAA-Compliant Concept Model (MHCCM)Medicaid Information Technology Architecture (MITA)Medicaid Management Information System (MMIS ,MMIS Interchange)Medicaid Statistical Information System (MSIS)Medicaid Utilization InformationMedical Assistance Customer Assistance Service Center (MACSC)Medical Assistance ProgramMedical Eligibility (ME)Medical ExpensesMedically Needy (MN)Medical Necessity (MN)Medical Review (MR)Medical Work GroupMedicareMedicare Buy-InMedicare Part AMedicare Part BMedicare Part DMedigapMegabyteMemorandum of Understanding (MOU)Mental Health Consortium (MHC)Mental Retardation/Developme NTAL Disabilities Waiver (MRDD)Mental Retardation (MR)MetadataMicromediaMIME Hypertext Markup Language (MHTML)Monthly EnrollmentMultimediaMultiple Domain Facililty (MDF)Multiple Virtual Storage (MVS)National Breast & Cervical Cancer Early Detection Program (NBCCEDP)National Committee for Quality Assurance (NCQA)National Council for Prescription Drug Programs (NCPDP)National Data Corporation/National Drug Code (NDC)National Drug Data File (NDDF)National Provider File (NPF)National Provider Identifier (Npi)National Provider System (NPS)National Standard Format (NSF)NCPDP ClaimNetwork Data Mover (NDM)Network Service Provider (NSP)New Day ClaimNew DrugNew Drug CoverageNon-Claim-Specific Accounts ReceivableNon-Covered Services (NC)Non Emergent Medical Transportation (NEMT)Non Steroidal Anti-Inflammatory Drugs (NSAIDS)NotesNotice of Proposed Rule Making (NPRM)Notification of DeathNot Otherwise Classified (NOC)Nurse Practitioner (NP)Nursing Facility for Mental Health (NF/MH)Nursing Facility for Skilled Nursing (NFSN)Nursing Facility (NF)ObjectOccupational Therapy (OT)OCR Data Recognition (OCR)Office of Information Services (OIS)Office of Management and Budget (OMB)Office of Medical Assistance Programs (OMAP)Old Age, Survivors, and Disability Insurance (OASDI)Omnibus Budget and Reconciliation Act of 1990 (OBRA-90)Omnibus Budget Reconciliation Act (OBRA)OndemandOnlineOnline Transaction Processing (OTP)Open FormularyOperating System (OS)Operational ProceduresOperational Trouble Report (OTR)Optical Work Order (OWO)OracleOregon Health Plan (OHP)Other DevelopmentalOther Insurance (OI)Outpatient CareOutpatient (OPT)OverrideOverscanOver the Counter (OTC)Paid ClaimPanelPanel HoldPaperless Inquiry and Claims System (PICS)ParameterPasswordPatientPatient Liability (PATLIAB)Payable CodesPay and ChasePayer of Last ResortPayment CyclePayout (PAY)PeerPeer Education and Resource Council (PERC)Peer GroupPeer ReviewPeer Review Organization (PRO)Pending (PEND)Per DiemPerforming ProviderPersonal Assistance Services (PAS)Personal Computer (PC)Personal Identification Number (PIN)Personal Responsibility and Work Opportunity Reconciliation Act 1996 (PRWORA)PF KeyPharmacistPharmacy Benefit Management (PBM)Pharmacy ContractorPharmacy Lock-InPharmacy Point of Sale (RX-POS, POS)Pharmacy Super PAPhysically Disabled Waiver (PD)Physical Therapy (PT)Physician (PHY, PHYS)Physicians Desk Reference (PDR)Place of Service (POS)Plan of CarePlatter Swap IntervalPoint of Sale (POS)Policy Work GroupPopulation CodePost Pay Bill (PPB)Poverty LevelPoverty Level Eligible (PLE)PractitionerPre Admission Screening (PAS)Pre-Certification (PRE- Cert)PremiumPrepayment ReviewPrevail/XPPricing Action Code (PAC)Pricing Indicator Code (PIC)Pricing Level Used (PLU)Pricing MethodPrimary CarePrimary Care Manager (PCM)Primary Care Network (PCN)Primary Care Provider/Case Manager (PCP/CM)Primary Care Provider (PCP)Primary Care ServicesPrimary Case Management (PCM)Primary Medical ProviderPrior Authorization and Case Management (PA/CM)Prior Authorization (PA)Prioritized ListProcedure, Drug, and Diagnosis File (PDDF FILE)Procedure (PROC)Processed ClaimPROC/NDCProcurement Negotiation Committee (PNC)Professional Component (PC)Professional Standards Review Organizations (PSRO)ProgramProgram Cost Account (PCA)Program of All- Inclusive Care for the Elderly (PACE)Project Invision (PIV)Project Management Body of Knowledge (PMBOK)Project Management Institute (PMI)Project Management Team (PMT)Project Management, Version 2 (PM2)Project Workbook (PWB)PromptProspective Drug Utilization Review (PRO- DUR)Prosthetics and Orthotics (P&O)ProtocolProviderProvider Automated Claims System (PACS)Provider Category of ServiceProvider ContractProvider Contract Billing RulesProvider Electronic Solutions (PES)Provider Enrollment (PE)Provider RelationsProvider Speciality (PS)Provider TypeProxy ServerPsychiatric HospitalPublic AssistancePublic Health Service (PHS)PurgeQualified Disabled Working Individual (QDWI)Qualified Medicare Beneficiary (QMB)Qualified Working Disabled (QWD)Qualitly Control (QC)QuarterQueryQueue DirectoryRailroad Retirement Board (RRB)Random AccessRandom Access Memory (RAM)Ratio ReportRealtime SystemReasonable ChargeRebate Per Unit (RPU)Rebate Per Unit (RPU)Recipient Eligibility Verification System (REVS)Recipient Explanation of Medical Benefits (REOMB)Recipient Master File (RMF)Recipient (RCPT, RE)Recipient SubsystemRecognition Research, Incorporated (RRI)RecordRecoupment (REC)Recoupment Type HierarchyRecycleRed BookRedundant Arrays of Inexpensive, or Independent Discs (RAID)Reference Data Maintenance SubsystemReformatRegion CodeRegulationRehabilitation TherapiesReimbursement AgreementRejected ClaimRelational DatabaseRelational Database Management System (RDBMS)Relative Value ScaleRelative Value Units (RVU)ReleaseRemittance Advice (RA, Remittance Adv)Remittance Advice Void (RAV)RemitterRemote Access Services (RAS)ReportReport CategoryReport LibraryReprocessRequest for Application (RFA)Request for Proposal (RFP)RequestorRequirements Tracebility Matrix (RTM)Requirements Validation Document (RVD)Requirements Validation Session (RVS)ResolutionResource Access Control Facility (RACF)Resource NameRespondentResponse CodeResubmission (Encounter)Resubmission (FFS)RetrieveRetrospective Drug Utlization Review (RETRO-DUR)Return to Provider (RTP)Revenue CodesRoute TableRules Based ProcessRun DateRural Health Clinic (RHC)SanctionScalingScanScannerScan RateSchool-Based ServicesScreen DefinitionScreen ScrapingSearchSenior Prescription Drug Assistance Program (SPDAP)Seniors and People with Disabilities (SPD)Sequential AccessServiceService LevelSeverely Emotionally Disturbed Waiver (SED)Simple Object Access Patrol (SOAP)Six Month EnrollmentSizeSkeleton ClaimSkilled Nursing Facility (SNF)Social Security Administration (SSA)Social Security Income (SSI)Social Security Number (SSN)Social Services (SS)Software Engineering Institute (SEI)SortingSpecialistSpecial ServicesSpecialtySpecified Low Income Medicare Beneficiaries (SLMB)Spenddown (SPN)Spyder ™ Analysis WebstationSQL ServerStakeholderStateState Children’s Health Insurance Program (SCHIP)State Data Center (SDC)State Data Exchange System (SDX)State Fiscal YearState Maximum Allowable Charge/Cost (SMAC)Statement on Auditing Standards (SAS)State Plan (SP)State Supplemental Program (SSP)State Wage Information Collection Agencies (SWICA)Statistical Package for Social Sciences (SPSS)Step Therapy Group (STG)Step Therapy Levels (STL)Stop-LossStorage ConfigurationStored Reference Object (SRO)Structured Query Language (SQL)Structured Query Language (SQL)SubcontractorSubject Matter Expert (SME)SubsistenceSummary DataSummary Profile Report (SPR)Supplemental Medical Insurance (SMI)Surveillance and Utilization Review Subsystem (SURS)Surveillance and Utilization Review (SUR)SuspendedSuspended AdjustmentSuspended ClaimSuspense File ListSybaseSysoutSysout Archival and Retrieval System (SARS)SystemSystem GeneratedSystem ObjectSystem Performance Review (SPR)SystemsSystems Life Cycle (SLC3)T-1 ConnectionTagged Image File Format (TIFF)Targeted QueryTechnical Component (TC)Technology Assisted Waiver (TA)Teleprocessing Monitor/Transaction Processing MonitorTemporary Assistance to Needy Families (TANF)Text-String SearchesThe Director’s OfficeTherapeutic ClassThird-Party AdministratorThird-Party Liabililty (TPL)Third-Party Resource (TPR)Third-Party SoftwareTicket to Work and Work Incentives Improvement Act (TWWIIA)TimeoutTitle I (1)Title IV (4)Title IV-ETitle X (10)Title XIV (14)Title XIX (T19)Title XVI (16)Title XVIII (18)Title XXI (T21)To date of service (TDOS)ToolbarTracking EventTrading PartnerTransaction ProcessingTransaction SetTransaction Set StandardsTransitional Living Training/Transitional Living Skills TrainingTranslatorTransmission Control Protocol/Internet Protocol (TCP/IP)Transportation BrokerTreatmentTrip SheetsTrunkTrunk GroupType of Services (TOS)UB-92UnderscanUnit DoseUnite Document ImagingUnited States Postal Service (USPS)Unit Rebate Amount (URA)UniverseUnixUploadUptimeUserUser IDUsual and Customary Charge (UCC ,U&C)Usual and Customary Rate (UCR)Utilization Management (UM)Utilization Review (UR/Utilization Rev)Vaccine for Children (VFC)Value-Added Network (VAN)VendorVirtual Private Network (VPN)Voice Gateway System (VGS)VoidWaiting TimeWaiverWarrantWarrant NumberWarrant TypeWeb PortalWindowsWithholdWorkers’ CompensationWorkgroupsWorkstationWork Units (DHS)Write-Offs
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Date
2016-06-10
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