You work in a pain specialist’s office. Perhaps you are the provider. Maybe you work at the front desk, or as a nurse practitioner or biller. Like any profession, pain specialists have a jargon that can be difficult to decode at first. This guide explains a few of the most common:
CMS: Centers for Medicare and Medicaid Services www.cms.gov
EHR: Electronic health record. This is, in part, a way of digitally capturing and storing patient data.
HICN: Health Insurance Claim Number
HIPAA: The Health Insurance Portability and Accountability Act of 1996 was signed by President Bill Clinton, in part to protect American’s health information. Title I of the act protects health insurance coverage for workers and their families when they change or lose their jobs. Title II is administrative and requires national standards for electronic health care transactions and national identifiers for providers (see above).
Your patients should be signing HIPAA waivers to know how their private data is being stored and secured. If you have questions about HIPAA – contact Boost. We can walk you through this important, and mandated, compliance step.
HITECH: Health Information Technology for Economic and Clinical Health Act was signed into law in 2009 as part of President Obama’s economic stimulation plan. This included incentives related to healthcare information technology, and specifically incentivized the use of electronic health record (EHR) systems among providers.
NPI: National provider identifier. The NPI has replaced the unique provider identification number (UPIN) as the required identifier for Medicare services, and is used by other payers, including commercial healthcare insurers. The transition to the NPI was mandated as part of the Administrative Simplifications portion of the Health Insurance Portability and Accountability Act of 1996 (HIPAA), and CMS began issuing NPIs in October 2006
PTAN – Provider Transaction Access Number – or a physician’s legacy Medicare ID number. Normally found in box 24J on a printed CMS HCFA, it starts with a letter. The National Plan and Provider Enumeration System has additional information, including a registry by provider and organization: https://nppes.cms.hhs.gov/NPPES/Welcome.do
SPR: Standard Provider Remittance