Definitions and Glossary Terms

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 All

Last updated 9/28/2010 10:48 AM Glossary Entries for All

ANSI
Standard X12 healthcare claim file transactions.
Channel Partners
IT companies who partner to provide an end to end solution that help automate the exchange of information between providers, health plans, clearinghouses, and other heathcare entities.
Clearinghouse
An entity that standardizes health information.
CORE
Committee on Operating Rules for Information Exchange.
Direct-Connectivity
Electronic transaction trading direct to the payer without going through a clearinghouse.
Doohickey
Doohickey reporting system for payers, which includes complete transaction status reports.
HCFA
Health Care Financing Administration.
HEDIS
Health Plan Employer Data & Information Set Managed care An initiative by the National Committee on Quality Assurance to develop, collect, standardize, and report measures of health plan performances.
HIPAA
The Health Insurance Portability and Accountability Act (HIPAA) of 1996.
HL7
(Health Level 7) ANSI-accredited standards for electronically defining clinical and administrative data in the healthcare industry. HL7 is one of several Standards Developing Organizations in healthcare. The "7" comes from application layer 7 in the OSI model, which is the highest level where programs talk to each other.
ICD-10
The International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) is a coding of diseases and signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or diseases, as classified by the World Health Organization (WHO).
NCPDP
National Council for Prescription Drug Programs.
NSF
National Standard Format - A proprietary, 320-byte flat file record format used to submit professional claims. Not a HIPAA standard.
Platform
Hardware architecture and software framework.
Point-to-Point
Direct to payer.
Proprietary
Print image or National Standard Format.
Real-time
HIPAA-standard ASC X12N format, supporting eligibility inquiry and response (270/271), claims status (276/277).
SNIP7
Implementation Guide-Specific Trading Partners.
Trading Partner
Healthcare Electronic Data Interchange Trading Partner.
UB-04
The standard, uniform bill (UB) for institutional healthcare providers that’s used throughout the U.S. is known as the UB-04, which replaced the UB-92 following a four-year study involving National Uniform Billing Committee (NUBC) members and various public surveys. The UB form is used by hospitals, nursing homes, hospice, home health agencies, and other institutional providers.

 
Copyright © 2002 - 2010 Post-n-Track Corporation.

2080 Silas Deane Highway  •  Rocky Hill, CT 06067  •  USA  •  P 860.257.2030  •  F 860.257.2035  •  info@post-n-track.com
Privacy Statement  •  Terms of Use  •  Enroll Now