Top 143 Health Insurance Abbreviations List

Navigating the world of health insurance can be daunting, especially with its myriad of abbreviations. Our comprehensive list of 143 health insurance abbreviations is designed to demystify the jargon, making it easier for you to understand policies, healthcare services, and regulatory terms. Let’s dive in!

Health Insurance Abbreviations List

Below is the list of health insurance abbreviations:

1. ACA: Affordable Care Act
2. ACO: Accountable Care Organization
3. AD&D: Accidental Death and Dismemberment
4. ADE: Adverse Drug Event
5. AEP: Annual Enrollment Period
6. AHIP: America’s Health Insurance Plans
7. AHRQ: Agency for Healthcare Research and Quality
8. ALOS: Average Length of Stay
9. AMA: American Medical Association
10. ANOC: Annual Notice of Change
11. AOB: Assignment of Benefits
12. APG: Ambulatory Payment Classification
13. APTC: Advanced Premium Tax Credit
14. ASC: Ambulatory Surgical Center
15. BBA: Balanced Budget Act
16. BCBS: Blue Cross Blue Shield
17. BID: Twice Daily
18. BMI: Body Mass Index
19. BPO: Business Process Outsourcing
20. CAC: Certified Application Counselor
21. CAH: Critical Access Hospital
22. CAP: Community-Acquired Pneumonia
23. CBO: Congressional Budget Office
24. CDHP: Consumer-Directed Health Plan
25. CHIP: Children’s Health Insurance Program
26. CLIA: Clinical Laboratory Improvement Amendments
27. CMS: Centers for Medicare & Medicaid Services
28. COB: Coordination of Benefits
29. COBRA: Consolidated Omnibus Budget Reconciliation Act
30. COPD: Chronic Obstructive Pulmonary Disease
31. CPT: Current Procedural Terminology
32. CRNA: Certified Registered Nurse Anesthetist
33. CSR: Cost Sharing Reduction
34. DAW: Dispense as Written
35. DME: Durable Medical Equipment
36. DRG: Diagnosis-Related Group
37. E&M: Evaluation and Management
38. EAP: Employee Assistance Program
39. EBP: Evidence-Based Practice
40. ECO: End-of-Care Option
41. ED: Emergency Department
42. EFT: Electronic Funds Transfer
43. EHR: Electronic Health Record
44. EOB: Explanation of Benefits
45. EPO: Exclusive Provider Organization
46. ERISA: Employee Retirement Income Security Act
47. ESRD: End-Stage Renal Disease
48. FFS: Fee-for-Service
49. FPL: Federal Poverty Level
50. FQHC: Federally Qualified Health Center
51. FSA: Flexible Spending Account
52. FTE: Full-Time Equivalent
53. GPO: Group Purchasing Organization
54. HCAHPS: Hospital Consumer Assessment of Healthcare Providers and Systems
55. HCBS: Home and Community-Based Services
56. HCPCS: Healthcare Common Procedure Coding System
57. HDHP: High Deductible Health Plan
58. HEDIS: Healthcare Effectiveness Data and Information Set
59. HHS: Department of Health and Human Services
60. HIE: Health Information Exchange
61. HMO: Health Maintenance Organization
62. HRA: Health Reimbursement Arrangement
63. HSA: Health Savings Account
64. ICD: International Classification of Diseases
65. IDR: Independent Dispute Resolution
66. IME: Indirect Medical Education
67. IPA: Independent Practice Association
68. IPPS: Inpatient Prospective Payment System
69. IRF: Inpatient Rehabilitation Facility
70. LTAC: Long-Term Acute Care
71. LTC: Long-Term Care
72. MA: Medicare Advantage
73. MAC: Medicare Administrative Contractor
74. MCO: Managed Care Organization
75. MDH: Medicare-Dependent Hospital
76. MEC: Minimum Essential Coverage
77. MedSup: Medicare Supplement
78. MIP: Medicare Integrity Program
79. MLR: Medical Loss Ratio
80. MMIS: Medicaid Management Information System
81. MSA: Medical Savings Account
82. MS-DRG: Medicare Severity Diagnosis-Related Group
83. MSP: Medicare Secondary Payer
84. NCD: National Coverage Determination
85. NDC: National Drug Code
86. NPI: National Provider Identifier
87. OEP: Open Enrollment Period
88. OIG: Office of Inspector General
89. OON: Out of Network
90. OOP: Out-of-Pocket
91. OTC: Over-the-Counter
92. PBM: Pharmacy Benefit Manager
93. PCMH: Patient-Centered Medical Home
94. PCP: Primary Care Physician
95. PDP: Prescription Drug Plan
96. PFFS: Private Fee-for-Service
97. PHO: Physician-Hospital Organization
98. PIP: Performance Improvement Plan
99. PMPM: Per Member Per Month
100. POS: Point of Service
101. PPO: Preferred Provider Organization
102. PQRS: Physician Quality Reporting System
103. PRN: As Needed
104. PSO: Provider-Sponsored Organization
105. PTAN: Provider Transaction Access Number
106. PTD: Paid to Date
107. QALY: Quality-Adjusted Life Year
108. QAPI: Quality Assessment and Performance Improvement
109. QHP: Qualified Health Plan
110. QMB: Qualified Medicare Beneficiary
111. RAC: Recovery Audit Contractor
112. RADV: Risk Adjustment Data Validation
113. RBRVS: Resource-Based Relative Value Scale
114. RHC: Rural Health Clinic
115. ROI: Release of Information
116. RUC: Relative Value Scale Update Committee
117. RVU: Relative Value Unit
118. SBIRT: Screening, Brief Intervention, and Referral to Treatment
119. SCHIP: State Children’s Health Insurance Program
120. SEP: Special Enrollment Period
121. SHIP: State Health Insurance Assistance Program
122. SLP: Speech-Language Pathology
123. SMD: State Medicaid Director
124. SNP: Special Needs Plan
125. SOB: Shortness of Breath
126. SPC: Specialty Pharmacy
127. SSI: Supplemental Security Income
128. TANF: Temporary Assistance for Needy Families
129. TCM: Transitional Care Management
130. TIN: Taxpayer Identification Number
131. TPA: Third Party Administrator
132. TRICARE: Health Care Program for Uniformed Service Members and their Families
133. UCR: Usual, Customary, and Reasonable
134. UM: Utilization Management
135. URAC: Utilization Review Accreditation Commission
136. VBP: Value-Based Purchasing
137. VFC: Vaccines for Children
138. VNA: Visiting Nurse Association
139. WC: Workers’ Compensation
140. WIC: Women, Infants, and Children
141. XaaS: Anything as a Service
142. YTD: Year-To-Date
143. ZPD: Zone of Proximal Development

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Health Insurance Terminology A-Z

List of Medical Abbreviations