Glossary of Terms

Term

Definition

ACHI

Arkansas Center for Health Improvement

AID

Arkansas Insurance Department

APCD

Arkansas All-Payer Claims Database

Data User

Individual or entity requesting data

DRG

Diagnosis Related Group — a statistical system of classifying any inpatient stay information into groups for the purpose of payment

DSG

APCD Data Submission Guide

HIEArkansas Health Insurance Exchange; also referred to as the Exchange

HIPAA

Health Insurance Portability and Accountability Act of 1996

NAIC Suffix

Single alpha character used with NAIC code to represent different data systems providing data for the same NAIC company code

NPI

A national unique identification number for covered healthcare providers

Provider

A “provider” is defined as a person or entity, including physicians, nurse practitioners, and physician assistants rendering medical care

Rule 100[1]

AID guidelines for submission of medical, dental, and pharmaceutical claims, unique identifiers and geographic and demographic information for covered individuals, and provider files to the Arkansas Healthcare Transparency Initiative for the purpose of creating and maintaining a multi-payer claims database as a source of healthcare information to support consumers, researchers, and policymakers in healthcare decisions within the state

Submitting Entity (SE)

An entity required to submit data per Act 1233 of 2015

TPAThird-party administrator

UAMS

University of Arkansas for Medical Sciences

1: “Proposed Rule 100: Arkansas Healthcare Transparency Initiative Standards.” Arkansas Insurance Department Proposed Rule 100 is issued pursuant to Act 1233 of 2015 of the Arkansas 90th General Assembly, also known as the “Arkansas Healthcare Transparency Initiative Act of 2015.” Accessed at: http://insurance.arkansas.gov/Legal/PropRules/PropRule100.pdf.