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Friday, April 26, 2024, 6:28 PM
Site: Healthy Connections Medicaid E-Learning
Course: Learning Resources (Learning Resources)
Glossary: Acronyms
A

ACA

Affordable Care Act

ADA

America Dental Association

AFDC

Aid to Families with Dependent Children

AG

Attorney General

ASO

Administrative Services Organization
B

BCBS

Blue Cross/Blue Shield
C

CARC

Claim Adjustment Reason Codes

CCN

Claim Control Number

CCR

Change Control Record

CLTC

Community Long-Term Care

CMS

Centers for Medicare & Medicaid Services

COB

Coordination of Benefits

CPT

Current Procedural Terminology

CSO

Care Coordination Services Organization
D

DDSN

Department of Disabilities and Special Needs

DEERS

Defense Eligibility and Enrollment Reporting System

DHEC

Department of Health and Environmental Control

DHHS

Department of Health and Human Services

DME

Durable Medical Equipment

DMH

Department of Mental Health

DOB

Date of Birth

DOS

Date of Service

DSS

Department of Social Services

DVR

Department of Vocational Rehabilitation
E

ECF

Edit Correction Form

EDI

Electronic Data Interchange

EFT

Electronic Funds Transfer

EMPS

Employee Performance Management System

EOB

Explanation of Benefits

EOMB

Explanation of Medicare Benefits

ER

Emergency Room

ERA

Electronic Remittance Advice

ESRD

End Stage Renal Disease
F

FAQs

Frequently Asked Questions

FFS

Fee-for-Service

FOIA

Freedom of Information Act

FTP

File Transfer Protocol
G

GAPS

Gap Assistance Pharmacy Program for Seniors
H

HCK

Healthy Connections Kids

HIIRF

Health Insurance Information Referral Form

HIPAA

Health Insurance Portability and Accountability Act

HIPP

Health Insurance Premium Payment Program

HMO

Health Maintenance Organization
I

IPC

Integrated Personal Care

ISP

Internet Service Provider

IVRS

Interactive Voice Response System
L

LIF

Low Income Families

LMS

Learning Management System
M

MARS

Management and Administration Reporting System

MCCS

Medicaid Claims Control System

MCO

Managed Care Organization

MEDS

Medicaid Eligibility Determination System

MHN

Medical Homes Network

MIVS

Medicaid Insurance Verification Service

MMIS

Medicaid Management Information System
N

NPI

National Provider Identification
O

OC

Other Coverage

OIG

Office of Inspector General

OSS

Optional State Supplementation
P

P/RSPCE

Preventive and Rehabilitative Services for Primary Care Enhancement

PA

Prior Authorization

PACE

Program of All Inclusive Care for the Elderly (PACE) program

PCCM

Primary Care Case Management

PCP

Primary Care Physician

PEP

Physician Enhanced Program

PHI

Protected Health Information

PMPM

Per-Member-Per-Month

POS

Point of Sale

PSC

Provider Service Center

Q

QI

Qualifying Individual

QMB

Qualified Medicare Beneficiary
R

RA

Remittance Advice

RARC

Remittance Advice Reason Codes

REF

Reasonable Effort
S

SAO

State Auditor’s Office

SCDHHS

South Carolina Department of Health and Human Services

SCHA

South Carolina Hospital Association

SCHCC

South Carolina Healthy Connections Choices

SCHIP

State Children’s Health Insurance Program

SCMSA

South Carolina Medicaid Service Area

SCMWBCST

South Carolina Medicaid Web Based Claims Submission Tool

SLMB

Special Low Income Medicare Beneficiary

SSA

Social Security Administration

SSI

Supplemental Security Income

SURS

Surveillance and Utilization Review System
T

TAD

Turn Around Document

TEFRA

Tax Equity and Fiscal Responsibility Act

TPA

Trading Partner Agreement

TPL

Third Party Liability
U

URL

Uniform Resource Locator
V

VA

Veteran’s Administration

VR

Void/Replacement
W

WIC

Women, Infant’s and Children’s Program

WMCC

Medically Complex Children’s Waiver Program

WT

Web Tool