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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