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  3. Learn What Acronyms Mean

Learn What Acronyms Mean

It can be hard to keep track of all the acronyms you need to know about your health coverage.

We've compiled a list of the most important ones so you can quickly look up anything you don't know as you make the most of your health insurance plan.

If you need definitions of important terms, visit our Glossary.

ACA: (Patient Protection and) Affordable Care Act 


ACO: Accountable Care Organization


AD&D: Accidental Death and Dismemberment


ADA: American with Disabilities Act of 1990


ALOS: Average Length of Stay


AMA: American Medical Association


APTC: Advanced Premium Tax Credit


ASC: Ambulatory Surgery Center


Auth: Authorization


BOI: Bureau of Insurance


CDHP: Consumer-Directed Health Plan


CHAMPUS: Civilian Hospital and Medical Program of the Uniformed Service. Now known as Tricare.


CHIP: Children's Health Insurance Program


CIN: Clinically Integrated Network


CMS: Centers for Medicare and Medicaid Services (previously HCFA)


COB: Coordination of Benefits


COBRA: Consolidated Omnibus Reconciliation Act (extension of coverage)


COI: Certificate of Insurance


CPT: Current Procedural Terminology (Level 1 codes)


DMAS: Department of Medical Assistance Services


DME: Durable Medical Equipment


DOL: Department of Labor


DOS: Date of Service


E & L: Exclusions and Limitations


EAP: Employee Assistance Program


EMT: Emergency Medical Technician


ENT: Ears, Nose and Throat


EOB: Explanation of Benefits


EOC: Evidence of Coverage (HMO / POS Plan Documentation)


ER: Emergency Room


ERISA: Employee Retirement Income Security Act


FAMIS: Family Access to Medical Insurance Security Plan


FDA: Food and Drug Administration


FEHBP: Federal Employee Health Benefit Plan


FFS: Fee for Service


FMLA: Family and Medical Leave Act


FSA: Flexible Spending Account


HDHP: High-Deductible Health Plan


HEDIS®: Health Plan Employer Data and Information Set


HIPAA: Health Insurance Portability and Accountability Act


HMO: Health Maintenance Organization


HRA: Health Reimbursement Account


HSA: Health Savings Account


ICU: Intensive Care Unit


IRF: Inpatient Reading Fee


IUD: Intrauterine Device


IV: Intravenous


JCAHO: Joint Commission on the Accreditation of Hospital Organizations


LOS: Length of Stay


LPN: Licensed Practical Nurse


LTD: Long Term Disability


Max: Maximum


MD: Medical Doctor


MOOP: Maximum Out of Pocket


MRI: Magnetic Resonance Imaging


NAIC: National Association of Insurance Commissioners


NCQA: National Committee for Quality Assurance


NIMH: National Institute of Mental Health


Non-par: Not participating (out-of-network)


NPI: National Provider Identifier


OB: Obstetrician


OOA: Out of Area


OOP: Out of Pocket


OSHA: Occupational Safety and Health Act


OTC: Over the Counter


OV: Office Visit


P&T: Pharmacy & Therapeutics Committee


Par: Participating


PCMH: Patient Centered Medical Home


PCP: Primary Care Physician


PHA: Personal Health Assessment


PHI: Protected Health Information


POA: Power of Attorney


POS: Point of Service


PPACA: Patient Protection and Affordable Care Act


PPO: Preferred Provider Organization


Pre-auth: Pre-Authorization


Pre-X: Pre-existing Conditions


PSA: Prostate Screening Antigen


PT: Physical Therapy


QHP: Qualified Health Plan


Remit: Remittance


Retro: Retroactive


RN: Registered Nurse


ROI: Release of Information


RX: Prescription


SBC: Uniform Summary of Benefits and Coverage


SF: Self-Funded


SNF: Skilled Nursing Facility


ST: Speech Therapy


STD: Short-Term Disability


TEFRA: Tax Equity and Fiscal Responsibility Act of 1982


TPA: Third-Party Administrator


TRICARE: Managed Healthcare System for military families


UCC: Urgent Care Center


URI: Upper Respiratory Infection


VA Hospital: Veterans Administration Hospital


WC: Worker's Compensation


WH: Withhold


WIC: Women, Infants and Children (supplemental food program)


YTD: Year to Date

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Sentara Health Plans and Optima Health are trade names of Sentara Health Plans, Sentara Health Insurance Company, Sentara Health Administration, Inc., and Sentara Behavioral Health Services, Inc. Optima Health Insurance Company is an additional trade name for Sentara Health Insurance Company. Virginia Premier Health Plan is an additional trade name for Sentara Health Plans. Optima Behavioral Health is an additional trade name for Sentara Behavioral Health Services, Inc. Optima Health Maintenance Organization (HMO) products, and Point-of-Service (POS) products, are issued and underwritten by Sentara Health Plans. Optima Preferred Provider Organization (PPO) products are issued and underwritten by Sentara Health Insurance Company. Sentara Health Administration, Inc. provides administrative services to group and individual health plans but does not underwrite benefits. All Optima Health plans have benefit exclusions and limitations and terms under which the policy may be continued in force or discontinued. Medicare products are administered under an agreement with Sentara Health Plans and the Centers for Medicare and Medicaid Services (CMS.) Medicaid and FAMIS products are administered under an agreement with Sentara Health Plans and the Virginia Department of Medical Assistance Services (DMAS.)