MHCP Enrolled Providers

Acronyms for DHS Health Care Programs and Procedures

A - B - C - D - E - F - G - H - I - L - M - N - O - P - Q - R - S - T - U - X

A

 

AC

Alternative Care

ADA

American Dental Association Claim Form

ADD-ADHD

Attention Deficit Disorder with Hyper Activity

ADL

Activities of Daily Living

ALS

Advanced Life Support

APRN

Advanced Practice Registered Practice Nurse

ARMHS

Adult Rehabilitative Mental Health Services

ASC

Ambulatory Surgical Center

AWP

Average Wholesale Price

B

 

BLS

Basic Life Support

BRU

Benefit Recovery Unit

C

 

C & TC

Child and Teen Checkups (see EPSDT)

CAC

Community Alternative Care

CADI

Community Alternatives for Disabled Individuals

CAF

Combined Application Form

CAPD

Continuous Ambulatory Peritoneal Dialysis

CASSP

Child Adolescent Service System Program

CBP

County Based Purchasing

CCDTF

Consolidated Chemical Dependency Treatment Fund

CCPD

Continuous Cycling Peritoneal Dialysis

CD

Chemical Dependency

CDT 07/08

Current Dental Terminology, 6th Edition

CFR

Code of Federal Regulation

CLIA

Clinical Laboratory Improvement Amendment

CM

Case Manager

CMA

Case Manager Associate

CMH

Children’s Mental Health

CMHC

Community Mental Health Center

CMS

Centers for Medicare & Medicaid Services (formerly HCFA)

CMS-1500

Professional Claim Form

CNM

Certified Nurse-Midwife

CNP

Certified Neonatal Nurse Practitioner

CNS

Clinical Nurse Specialist

CNS-MH

Clinical Nurse Specialist – Mental Health

COB

Coordination of Benefits/Other Insurance

COBRA

Consolidated Omnibus Budget Reconciliation Act

CORF

Comprehensive Outpatient Rehabilitation Facility

CPHN

Certified Public Health Nurse

CPT

(Physician's) Current Procedural Terminology

CRNA

Certified Registered Nurse Anesthetist

CRRT

Continuous Renal Replacement Therapy

CTSS

Children’s Therapeutic Support Services

CY

Calendar Year (January 1 through December 31)

D

 

DAW

Dispense as Written (brand necessary)

DD

Developmental Disability

DESI

Drug Efficacy Study Implementation

DFC

Drug Formulary Committee

DHS

(Minnesota) Department of Human Services

DME

Durable Medical Equipment

DMERC

Durable Medical Equipment Regional Carrier

DOB

Date of Birth

DOS

Date of Service

DPA

Disproportionate Population Adjustment

DRG

Diagnosis-Related Group

DT&H

Day Training and Habilitation

DUR

Drug Utilization Review board

Dx

Diagnosis Code

E

 

EAAC

Estimated Actual Acquisition Cost

ED

Emotional Disturbance

EDI

Electronic Data Interchange

EFT

Electronic Funds Transfer

E & M

Evaluation and Management

EIN

Employee Identification Number

EOB

Explanation of Benefits

EOMB

Explanation of Medical Benefits

EPO

Epoetin

EPSDT

Early and Periodic Screening, Diagnosis and Treatment (see Child and Teen Checkups)

ESRD

End-Stage Renal Disease

EVS

Eligibility Verification System

EW

Elderly Waiver

F

 

FCSS

Family Community Support Services

FECA

Federal Employees’ Compensation Act

FFS

Fee-For-Service

FL

Form Locator (used in MHCP claim filing)

FQHC

Federally Qualified Health Center

FY

Fiscal Year (State FY July 1 – June 30)

G

 

GAMC

General Assistance Medical Care

H

 

HBMHS

Home Based Mental Health Services

HCBS

Home and Community Based Services

HCDPP

Health Care Designated Providers Program (formerly PCUR)

HCPCS

Healthcare Common Procedural Coding System

HHA

Home Health Agency or Home Health Aide

HIPAA

Health Insurance Portability & Accountability Act

HMO

Health Maintenance Organization

I

 

IBP

Individual Behavior Plan

ICD-9-CM

International Classification of Diseases 9th Revision Clinical Modification

ICF-DD

Intermediate Care Facility for the Developmentally Disabled

ICSP

Individual Community Support Plan

IEP

Individual Education Plan

IFSP

Individualized Family Service Plan

IMD

Institution for Mental Disease

IPD

Intermittent Peritoneal Dialysis

ITP

Individual Treatment Plan

ITS

Information Transfer System - the DHS modem-based billing system for MHCP claims

L

 

LICSW

Licensed Independent Clinical Social Worker

LMFT

Licensed Marriage and Family Therapist

LPN

Licensed Practical Nurse

LP

Licensed Psychologist

LPP

Licensed Psychological Practitioner

LTC

Long Term Care

M

 

MA

Medical Assistance

MAC

Maximum Allowable Cost

MFCU

Medicaid Fraud Control Unit

MCP

Monthly Capitation Payment

MCSHN

Minnesota Children with Special Health Needs

MDH

Minnesota Department of Health

MFIP

Minnesota Family Investment Program

MH

Mental Health

MHBA

Mental Health Behavioral Aide

MHCA

Minnesota Comprehensive Health Association

MHCP

Minnesota Health Care Programs

MH-TCM

Mental Health Targeted Case Management

MI

Mental Illness

MIA Counts

Medicare Inpatient Adjudication Counts (days)

MLB

MinnesotaCare Limited Benefit

MMIS

Medicaid Management Information System

MMR

Measles/Mumps/Rubella

MN-ITS

("Minutes") The DHS HIPAA-compliant billing system for electronically submitted MHCP claims and other transactions (replaces ITS).

MOD

Modifier (abbreviation)

MPAF

Minnesota Pregnancy Assessment Form

DD/RC

Developmental Disability or Related Condition

MRI

Magnetic Resonance Imaging

MSHO

Minnesota Senior Health Option

N

 

NCPDP

National Council for Prescription Drug Programs

NDC

National Drug Code

NF

Nursing Facility

NPI

National Provider Identifier

NSF

National Standard Format

O

 

OJT

On the Job Training

OPPS

Outpatient Prospective Payment System

OT

Occupational Therapist

OTA

Occupational Therapist Assistant

P

 

PA

Prior Authorization

PAS

Pre-Admission Screening

PCA

Personal Care Assistant

PCN

Paper Claim Control Number (formerly TCN)

PCPO

Personal Care Provider Organization

PCUR

See HCDPP

PDF

Portable Document Format

PDN

Private Duty Nurse

PDP

Prescription Drug Program

PGAMC

Prepaid General Assistance Medical Care

PHN

Public Health Nurse

PHNC

Public Health Nursing Clinic

PMAP

Prepaid Medical Assistance Program

PMHCP

Prepaid Minnesota Health Care Programs

PMI

Person Master Index

POS

Point Of Sale or Place Of Service

PPHP

Prepaid Health Plan

PPMP

Provider Performed Microscopy Procedures

PT

Physical Therapist

PTA

Physical Therapist Assistant

Q

 

QI

Qualifying Individual

QMB

Qualified Medicare Beneficiary

QWD

Qualified Working Disabled individual

R

 

RA

Remittance Advice

RHC

Rural Health Clinic

RN

Registered Nurse

RSC

Relocation Service Coordination

RSN

Reason Code

RTC

Regional Treatment Center

Rx

Prescription

S

 

SA

Service Agreement

SED

Severe emotional disturbance

SIRS

Surveillance & Integrity Review Section

SLMB

Service Limited Medicare Beneficiary

SLP

Speech-Language Pathologist

SMO

Second Medical Opinion

SNF

Skilled Nursing Facility

SPMI

Serious and Persistent Mental Illness

SSA

Social Security Administration

T

 

TBI-NB

Traumatic Brain Injury - Neurobehavioral Hospital

TBI-NF

Traumatic Brain Injury - Nursing Facility

TBIW

Traumatic Brain Injury Waiver

TD

Tetanus and Diphtheria

TEFRA

Tax Equity and Fiscal Responsibility Act

TPL

Third Party Liability

TPN

Total Parenteral Nutritional

TSFC

Therapeutic Support of Foster Care

U

 

UB-92

Universal Biller Claim Form

UCR

Usual, Customary and Reasonable

UMPI

Unique Minnesota Provider Identifier, the “NPI” for MHCP-enrolled atypical providers

V

 

VA/DD-TCM

Targeted Case Management Benefit for Vulnerable Adults and Adults with Developmental Disabilities

X

 

X12

HIPAA-compliant electronic format to submit and receive batch transactions between providers/ clearinghouses and health care payers. Requires X12-compliant software and submission/retrieval of batch transactions via MN-ITS Batch

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