Insurance Terms & Abbreviations

TERMS		DESCRIPTION
ADA		Americans with Disabilities Act
AHI		Account Handling Instructions
AME		Agreed Medical Exam
ARE		Actual Reduced Earnings
ASI		Account Service Instructions
AWW		Average Weekly Wage
C/R		Causal Relationship or Causally Related
CIB		Central Index Bureau
DOI		Date of Injury
DOL		Date of Loss
Dx		Diagnosis
EE		Employee
ER		Employer
ERTW		Estimated Return to WorkorEarly Return to Work
FBCM		Field-based Case Management
FCE		Functional Capacity Evaluation
FCRD		Further Causally Related Disability
FD		Full Duty
FMLA		Family & Medical Leave Act
FTE		Full-Time Equivalent (Employee)
Hx		History
IME		Independent Medical Evaluation/Examination
Incurred		All costs which have been paid and reserved.
IND		Indemnity. Lost wages which are paid
LD		Light Duty – another term for transitional duty
LOV		Last office visit
LT		Lost Time
LTD		Long Term Disability
MD		Modified Duty – another term for transitional duty
MDA		Modified Duty Assignment
MMI		Maximum Medical Improvement
MO		Medical-Only, Med-Only. No time lost from work
NCM		Nurse Case Management
NOV		Next Office Visit
OOW		Out Of Work
OSHA		Occupational Safety and Health Agency
OT		Occupational Therapy
OTC		Over the Counter (Drugs)
P & S		Permanent and Stationary (similar to MMI)
Paid		Costs that have been paid to medical providers, the employee or for expenses.
PIR		Permanent Impairment Rating
POA		Plan of Action
PPD		Permanent Partial Disability
PPI		Prior Permanent Impairment
PPL		Push, Pull, Lift
PT		Physical Therapy
PTD		Permanent Total Disability
QME		Qualified Medical Exam (similar to IME)
RD		Restricted Days
RE		Reduced Earnings
Reserved		Money that has been set aside to cover future claim costs.
RFP		Request for Proposal
RM		Risk Management
RMIS		Risk Management Information Systems
ROM		Range of Motion
RTW		Return-To-Work
Rx		Prescription
SAI		Special Account Instructions
SHI		Special Handling Instructions
SIF		Second Injury Fund
SLU		Schedule Loss of Use
SS		Social Security
SSDB		Social Security Disability Benefits
SSDI		Social Security Disability Insurance
SSI		Supplemental Security Income (disability payments for people without enough reported earnings to qualify for SSDB)
STD		Short Term Disability
Sx		Surgery
TAF		Transitional Assignment Form m
TD/TAD		Transitional Duty/ Transitional Alternate Duty
TPA		Third Party Administrator
TPD		Temporary Partial Disability
TTD		Temporary Total Disability. Temporarily not able to work.
Tx		Treatment
VAO		Valued As Of (a certain date)
WAF		Work Ability Form
WC		Workers’ Compensation
WCB		Workers’ Compensation Board

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CENTER OF MEDICARE AND MEDICAID SERVICES ABBREVIATIONS * (CMS)

TERMS		DESCRIPTION
AD		Account Designee. Assigned by the Account Manager
AM		Account Manager. Assigned by the Authorized Representative
AR		Account Representative. Can contractually bind the insurer
COBC		Coordination of Benefits Center. Responsible for receiving MQF and MIR files
COBSW		Coordination of Benefits Secure Web-Site. For RRE registration processing
CPCP		Conditional Payment
CPR		Conditional Payment Research
CMS		Centers for Medicare & Medicaid Services
CSA		Claim Settlement Allocation
EDI		Electronic Data Interface
LC		Lead Contractor, see MSPRC
MIR		Mandatory Insurer Reporting
MMSEA		Medicare & Medicaid State Children’s Health Insurance Program Extension Act
MQF		Medicare Query Function. Used to determine Medicare eligibility & reporting requirements
MSA		Medicare Set Aside. Allocation
MSP		Medicare Secondary Payer
MSPRC		Medicare Secondary Payer Recovery Contractor. Responsible for recovery of CP
NAIC		National Association of Insurance Commissioners
NGHP		Non-Group Health Plans. Workers’ compensation, liability, auto NF
PIN		Personal Identification Number. For COBSW
RRE		Responsible Reporting Entity
RRE ID		Responsible Reporting Entity Identification
SCHIP		State Children’s Health Insurance Program
SFTP		Secure File Transfer Protocol
S/J/A		Settlement/Judgment/Award
TIN		Tax Identification Number
TPA		Third Party Administrator
TPOC		Total Payment Obligation of Claimant