Insurance Terms & Abbreviations:

Insurance Terms & Abbreviations Worker's CompNSURANCE TERMS & ABBREVIATIONS

TERMSDESCRIPTION
ADAAmericans with Disabilities Act
AHIAccount Handling Instructions
AMEAgreed Medical Exam
AREActual Reduced Earnings
ASIAccount Service Instructions
AWWAverage Weekly Wage
C/RCausal Relationship or Causally Related
CIBCentral Index Bureau
DOIDate of Injury
DOLDate of Loss
DxDiagnosis
EEEmployee
EREmployer
ERTWEstimated Return to Work or Early Return to Work
FBCMField-based Case Management
FCEFunctional Capacity Evaluation
FCRDFurther Causally Related Disability
FDFull Duty
FMLAFamily & Medical Leave Act
FTEFull-Time Equivalent (Employee)
HxHistory
IMEIndependent Medical Evaluation/Examination
IncurredAll costs which have been paid and reserved.
INDIndemnity. Lost wages which are paid
LDLight Duty – another term for transitional duty
LOVLast office visit
LTLost Time
LTDLong Term Disability
MDModified Duty – another term for transitional duty
MDAModified Duty Assignment
MMIMaximum Medical Improvement
MOMedical-Only, Med-Only. No time lost from work
NCMNurse Case Management
NOVNext Office Visit
OOWOut Of Work
OSHAOccupational Safety and Health Agency
OTOccupational Therapy
OTCOver the Counter (Drugs)
P & SPermanent and Stationary (similar to MMI)
PaidCosts that have been paid to medical providers, the employee or for expenses.
PIRPermanent Impairment Rating
POAPlan of Action
PPDPermanent Partial Disability
PPIPrior Permanent Impairment
PPLPush, Pull, Lift
PTPhysical Therapy
PTDPermanent Total Disability
QMEQualified Medical Exam (similar to IME)
RDRestricted Days
REReduced Earnings
ReservedMoney that has been set aside to cover future claim costs.
RFPRequest for Proposal
RMRisk Management
RMISRisk Management Information Systems
ROMRange of Motion
RTWReturn-To-Work
RxPrescription
SAISpecial Account Instructions
SHISpecial Handling Instructions
SIFSecond Injury Fund
SLUSchedule Loss of Use
SSSocial Security
SSDBSocial Security Disability Benefits
SSDISocial Security Disability Insurance
SSISupplemental Security Income (disability payments for people without enough reported earnings to qualify for SSDB)
STDShort Term Disability
SxSurgery
TAFTransitional Assignment Form m
TD/TADTransitional Duty/ Transitional Alternate Duty
TPAThird Party Administrator
TPDTemporary Partial Disability
TTDTemporary Total Disability. Temporarily not able to work.
TxTreatment
VAOValued As Of (a certain date)
WAFWork Ability Form
WCWorkers’ Compensation
WCBWorkers’ Compensation Board

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CENTER OF MEDICARE AND MEDICAID SERVICES ABBREVIATIONS * (CMS)

 

TERMSDESCRIPTION
ADAccount Designee. Assigned by the Account Manager
AMAccount Manager. Assigned by the Authorized Representative
ARAccount Representative. Can contractually bind the insurer
COBCCoordination of Benefits Center. Responsible for receiving MQF and MIR files
COBSWCoordination of Benefits Secure Web-Site. For RRE registration processing
CPCPConditional Payment
CPRConditional Payment Research
CMSCenters for Medicare & Medicaid Services
CSAClaim Settlement Allocation
EDIElectronic Data Interface
LCLead Contractor, see MSPRC
MIRMandatory Insurer Reporting
MMSEAMedicare & Medicaid State Children’s Health Insurance Program Extension Act
MQFMedicare Query Function. Used to determine Medicare eligibility & reporting requirements
MSAMedicare Set Aside. Allocation
MSPMedicare Secondary Payer
MSPRCMedicare Secondary Payer Recovery Contractor. Responsible for recovery of CP
NAICNational Association of Insurance Commissioners
NGHPNon-Group Health Plans. Workers’ compensation, liability, auto NF
PINPersonal Identification Number. For COBSW
RREResponsible Reporting Entity
RRE IDResponsible Reporting Entity Identification
SCHIPState Children’s Health Insurance Program
SFTPSecure File Transfer Protocol
S/J/ASettlement/Judgment/Award
TINTax Identification Number
TPAThird Party Administrator
TPOCTotal Payment Obligation of Claimant

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