| Word |
Description |
| Adjudication Date |
This is the date claim was processed by the Insurance carrier |
| Autopost |
Autopost will automatically post your payments for specified carriers. |
| CCN |
Claim Control Number |
| Claim Memo |
Memo that was created for a specific claim. |
| CLIA |
CLIA - Clinical Laboratory Improvement Amendments
A federally mandated set of certification criteria and data collection monitoring system designed to ensure the proper certification of clinical laboratories |
| CMS |
Centers for Medicare and Medicaid Services
The Federal agency that oversees the Medicare and Medicaid programs. |
| DEA Number |
Number assigned to prescribing providers (e.g. physicians) as a part of controlled substances management |
| DLS |
Date Last Seen |
| DOA |
Date of Admission |
| DOS |
Date of Service |
| EFT |
Electronic Funds Transfer |
| EOB |
Explanation of Benefits |
| EOMB |
Explanation of Medicare Benefits |
| ePACES |
ePACES is the acronym for the Electronic Provider Assisted Claim Entry System, a web-based application which will allow Providers to create/submit claims and other transactions in HIPAA format. Computer Sciences Corporation (CSC) developed this application on behalf of the NYS Department of Health.
This is currently the only method ICS supports to send claims
|
| ERA |
Electronic Remittance Advice |
| ETIN |
This was formerly known as TSN. An ETIN is a number required for a provider to submit electronic claims to Medicaid. The ETIN is assigned by CSC and is linked to a provider’s Medicaid ID number by a Certification Statement. Both forms are available on this website. Look in the Featured Links Section and click on Provider Enrollment Forms. (NY State)
|
| HIC Number |
Health Insurance Claim number
Number used to identify Medicare beneficiaries |
| HIPAA |
Health Insurance Portability and Accountability Act of 1996 |
| Macro |
Macros are a compilation of commonly billed diagnosis and procedure codes. When creating a macro, all components of the claim's diagnosis and procedure code, modifiers, place and type of service, DX reference are created in one window and used in the billing window by typing a . (period) and pressing Enter. This eliminates the need to re-enter claims over and over.
|
| PCP |
Primary Care Provider |
| PDF |
Portable Document Format |
| PIN |
Provider Identification Number |
| POS |
Place of service |
| PTAN |
Provider Transaction Access Number- In short this is a doctor's legacy provider number |
| SA |
SA - Service Authorization
Service Authorization is required prior to providing services included in the Utilization Threshold (UT) Program. CSC matches the service authorization information with the appropriate claim data to pay the claim. Providers must obtain a UT service authorization via the Medicaid Eligibility Verification System (MEVS). Detailed information about service authorizations and the UT Program can be found at this website. Select NYHIPAADESK, then click on Provider Training Materials and choose Utilization Threshold Program. Detailed information about how to obtain a service authorization can also be found in the MEVS Provider Manual located in the Provider Manuals section of this website. |
| TOS |
Type of Service |
| U&C |
Usual & Customer Charge |
| UT |
Utilization Threshold
The Utilization Threshold (UT) program places limits on the number of services a Medicaid recipient may receive in a benefit year. A benefit year is a 12-month period, which begins the month in which the patient becomes Medicaid eligible. Detailed information about the UT Program can be found in the NYHIPAADESK section of this website, Click on Provider Training Materials. |