r/PatientPowerUp • u/CrumbCakesAndCola • 9d ago
So many acronyms - this list is mainly health / insurance but I included relevant corporate and tech acronyms as well. Feel free to add (or ask for) any I missed
Edit 1: readability and spelling (2025-08-20)
Edit 2: factual updates (2025-08-20)
Acronym | Expansion | Notes
AAC | Actual Acquisition Cost | How much the pharmacy paid to get the drug
ACH | Automated Clearing House | Network used for routine fund transfers like paychecks or monthly debits
ACO | Accountable Care Organization
AHH | American Health Holding | A medical benefit manager currently owned by Aetna which is in turn owned by CVS (2025)
AMA | American Medical Association
API | Application Programming Interface
ARRA | American Recovery and Reinvestment Act of 2009
AWP | Average Wholesale Price | A benchmark for wholesale pricing but not related to market price for the consumer (generally Rx)
BAA | Business Associate Agreement | relationship between HIPAA-covered entities and business associates
CAH | Critical Access Hospital
CAHPS | Consumer Assessment of Healthcare Providers and Systems
CCD | Continuity of Care Document
CCN | CMS Certification Number
CDH | Consumer Driven Health | A plan that allows utilizing pretax money to cover expenses Similar to HSA or HRA
CDS | Clinical Decision Support
CDT | Certified Dental Technicians | Defines a code set for dental procedures
CEHRT | Certified Electronic Health Record Technology
CFR | Code of Federal Regulations
CHC | Change HealthCare | Owned by UnitedHealthcare Group
CHIP | Children's Health Insurance Program
CHIPRA | Children's Health Insurance Program Reauthorization Act of 2009
CMS | Centers for Medicare & Medicaid Services
COB | Coordination of Benefits | Which plan pays first when multiple plans cover it
CPOE | Computerized Provider Order Entry
CPT | Current Procedural Terminology | A procedure code set defined by the AMA
CQM | Clinical Quality Measure
CX | Customer Experience
DBA | Doing Business As | When a company brands itself differently in different locations especially common when one company buys another
DED | Deductible
DME | Durable Medical Equipment | e.g. a wheelchair is DME but bandages are not
EDI | Electronic Data Interchange
EHR | Electronic Health Record
EIN | Employer Identificaion Number | A tax ID issued by the IRS
EME | Eligible Medical Expense
EOB | Explanation of Benefits
EP | Eligible Professional
EPO | Exclusive Provider Organization
EPR | Electronic Patient Record
ESI | Express Scripts | Used to be Express Scripts Inc before Cigna bought them
FACA | Federal Advisory Committee Act
FDA | Food and Drug Administration
FFP | Federal Financial Participation
FFY | Federal Fiscal Year
FFS | Fee-For-Service
FQHC | Federally Qualified Health Center
FTE | Full-Time Equivalent
FY | Fiscal Year
GCP | Good Clinical Practice
HCA | Health Care Authority
HCFA | Health Care Financing Administration | Now CMS, this billing format is for individual practitioners
HCPC | Health and Care Professions Council | Formerly HPC - Manages/defines a code set for medical procedures etc
HEDIS | Healthcare Effectiveness Data and Information Set
HHS | Department of Health and Human Services
HIE | Health Information Exchange
HIT | Health Information Technology
HITPC | Health Information Technology Policy Committee
HIPAA | Health Insurance Portability and Accountability Act of 1996
HITECH | Health Information Technology for Economic and Clinical Health Act
HMO | Health Maintenance Organization
HMS | Healthcare Management Systems | HMS Holdings Corp
HOS | Health Outcomes Survey
HPC | Health and Care Professions Council | Now HCPC - Manages/defines a commonly used code set
HPSA | Health Professional Shortage Area
HRA | Health Reimbursement Account
HRSA | Health Resource and Services Administration
IAPD | Implementation Advance Planning Document
IBNR | Incurred But Not Reported
ICD | International Classification of Diseases | Diagnosis codes defined by WHO
ICR | Information Collection Requirement
ID | Identifier
IHS | Indian Health Service
IPA | Independent Practice Association
IRB | Institutional Review Board | Groups intended to provide ethics and safety oversight in clincal trials
IRN | Integrated Repricing Network | Optum related to claims
IRR | Insight Record Review | Optum app related to claims
IRS | Internal Revenue Service
IS | Information Services
IT | Information Technology
LOB | Line of Business
LOINC | Logical Observation Identifiers and Codes System | standard for identifying health measurements
MA | Medicare Advantage
MAC | Maximum Allowable Cost | Max the plan will pay (generally Rx)
MAC | Medicare Administrative Contractor
MAO | Medicare Advantage Organization
MCO | Managed Care Organization
MI | Medical Integrator | This term is sometimes used to refer to groups that coordinate data
MIPS | Merit-based Incentive Payment System | Medicare-related
MITA | Medicaid Information Technology Architecture
MMIS | Medicaid Management Information Systems
MOOP | Maximum Out of Pocket
MSA | Medical Savings Account
MSP | Medicare Secondary Payer
NAAC | Net Average Allowable Cost | CEHRT-related
NCPDP | National Council for Prescription Drug Programs
NCQA | National Committee for Quality Assurance
NCVHS | National Committee on Vital and Health Statistics
NDC | National Drug Code
NPI | National Provider Identifier
NPRM | Notice of Proposed Rulemaking
OE | Open ENrollment
ONC | Office of the National Coordinator for Health Information Technology
OOP | Out of Pocket
PAHP | Prepaid Ambulatory Health Plan
PAPD | Planning Advance Planning Document
PCP | Primary Care Provider
PECOS | Provider Enrollment Chain and Ownership System
PFFS | Private Fee-For-Service
PHO | Physician Hospital Organization
PHR | Personal Health Record
PHS | Public Health Service
PHSA | Public Health Service Act
PI | Prinipal Investigator | Lead researcher in a clinical trial
PIHP | Prepaid Inpatient Health Plan
POS | Place of Service
PPO | Preferred Provider Organization
PQRS | Physician Quality Reporting System
PSO | Provider Sponsored Organization
QLE | Qualifying Life Event | Events that allow you to make changes to your health insurance outside the usual timeframe of the contract
QPP | Quality Payment Program | of Medicare
REV | Revenue Code Type
RHC | Rural Health Clinic
RPPO | Regional Preferred Provider Organization
RX | Prescription | It's from the Latin word "Recipe" which was abbrieviated by a strike through the R
SAMHSA | Substance Abuse and Mental Health Services Administration
SMHP | State Medicaid Health Information Technology Plan
SNF | Skilled Nursing Facility | Generally long term care
SPD | Summary Plan Description
SSN | Social Security Number
TIN | Tax Identification Number | For an individual this is usually the SSN, for a provider its usually the EIN
TMR | Transmittal of Medical Records
TPA | Third Party Administrator
UB | Uniform Bill | Format used for institutions like hospitals
UC | Usual and Customary | The typical retail price without insurance
UCR | Usual and Customary Rates | The typical retail price without insurance
UMR | United Medical Resources | This is a TPA owned by UnitedHealthcare Group
VA | Veteran Affairs
VHA | Veteran Health Administration
WHO | World Health Organization
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u/Old_Glove9292 9d ago
Super helpful. I've stickied the post. Thanks!