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Download Provider Electronic Solutions Software User`s Manual
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PA PROMISe™ Provider Electronic Solutions Software User Manual Version 4.00 17 Appendix C - Glossary of Terms Acronym/ Word ACCESS ID Card Access Plus Program CAO CARC Carrier Code CCR CIS CRN Diagnosis DOB DOD DOI DOS DHS Drop down list EOMB ERA EFT HCSIS HIPAA ICD-9-CM ICD-10CM/PCS ICN PROMISe™ Legacy Numbers MA MA ID MCO MAMIS MMIS NCPDP Description Medical Assistance plastic ID card issued to recipients. Enhanced primary care case management and disease management program. Refer to Bulletin 99-06-11 for instructions. County Assistance Office – these offices administer all DHS benefit programs at the local level. Claim Adjustment Reason Codes Number assigned to a specific insurance company. Consolidated Community Reporting for OMHSAS Client Information System Claim Reference Number Identity of a condition, cause, or disease. Date of Birth Date of Death Department of Insurance Date of Service Department of Human Services – sometimes called the department. Also known as a reference list. Explanation of Medical Benefits Electronic Remittance Advice Electronic Funds Transfer Home and Community Services Information System Health Insurance Portability and Accountability Act of 1996 International Classification of Diseases, 9th Revision, Clinical Modification. International Classification of Diseases, 10th Revision, Clinical Modification. Internal Control Number – unique claim number that distinguishes claims within PROMISe™ and appears on a Remittance Advice statement. Pennsylvania Medical Assistance Legacy Numbers – Master Provider Index (MPI) number – a 13 digit number that consist of the 9 digit provider ID and a 4 digit location number. Medical Assistance Medical Assistance Identification number Managed Care Organization Medical Assistance Management Information System Medicaid Management Information System National Council of Prescription Drugs Program – An ANSI accredited group that maintains a number of standard formats for use by the retail industry. R:\PA MMIS\CMcElheny\PES_Manual_5010 4.00_ICD10.docx August 31, 2015 378
