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 Work or Early 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 |
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 |
