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terms and abbreviations

accredited standars committee x12

the U.S. standards body formed by the American National Standards Institute for cross-industry development, maintenance, and publication of electronic data exchange standards

application service provider

a practice management system available over the internet in which data are housed on the server of the ASP but the accounts are managed by the health care providers staff

back up

a duplicate data file

business associate agreement

contract between the provider and a clearinghouse that submits the electronic claims on behalf of the provider

cable modem

a modem used to connect a computer to a cable television system that offers online services


an independent organization that receives insurance claims from the physician's office, performs software edits, and redistributes the clams electronically to various insurance companies

code sets

any set of codes with their descriptions used to encode date elements such as tables of terms, medical concepts, medical diagnostic codes, or medical procedure codes

covered entity

an entity that transmits health information in electronic form in connection with a transaction covered by HIPAA

data elements

medical code sets used uniformly to document why patients are seen and what is done to them during their encounter procedure

digital subscriber line

a high-speed connection through a telephone line jack and usually a means of accessing the internet

direct data entry

keying claim information directly into the payer system by accessing over modem dial-up or DSL

electronic data interchange

the process by which understandable data items are sent back and forth via computer linkages between two or more entities that function alternatively as sender and receiver

electronic funds transfer

a paperless computerized system enabling funds to be debited, credited, or transferred, eliminating the need for personal handling of checks

electronic remittance advice

an online transaction about the status of a claim


an add-on software to practice management systems that can reduce the time it takes to build or review insurance claims before batch transmission to the carrier


to assign a code to represent data, this is done for security purposes

HIPAA transaction and code set rule

this regulation under HIPAA defines the standardized methods for transmitting electronic health information

national standard format

the name of the standardization of data to reduce paper and have more accurate information and efficient organization


a combination of letters and numbers that each individual is assigned to access computer data

real time

online interactive communication between two computer systems allowing instant transfer of information

standard transactions

the electronic files in which medical data are compiled to produce a specific format


a T-carrier channel that can transmit voice or data channels quickly

taxonomy codes

numeric and alpha provider specialty codes that are assigned and classify each health care provider when transmitting electronic insurance claims


American National Standards Institute

ASC x12

Accredited Standards Committee x12


administrative simplification enforcement tool


application service provider


automatic teller machine


direct data entry


digital subscriber liner


electronic data interchange


electronic funds transfer


electronic health record


electronic medical claim


explanation of Medicare benefits


electronic protected health information


electronic remittance advice


U.S. Department of Health and Human Services


internal revenue service


medicare transaction system


nonsufficient funds


practice management software, practice management system

TCS rule

HIPAA transaction and code set


uinterruptible power supply

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