Glossary of Terms (Non-Claims)
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 — DRG is a statistical system of classifying any inpatient stay information into groups for the purpose of payment |
DSG | APCD Data Submission Guide |
HIE | Arkansas 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 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 |
TPA | Third-party administrator |
Submitting Entity | An entity required to submit data per Act 1233 of 2015 |
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.” http://insurance.arkansas.gov/Legal/PropRules/PropRule100.pdf.