A HIPAA Glossary, continued
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Contents
Part I (A HIPAA Glossary) gives general definitions and
explanations of HIPAA-related terms and acronyms.
Part II (Consolidated HIPAA
Administrative Simplification Final Rule Definitions) shows
all definitions included in the final HIPAA A/S rules as of 01/20/2001.
Part III (Purpose &
Maintenance) is self-explanatory.
Part I: A HIPAA Glossary
Please note that whenever a definition occurs in both
Part I and Part II, the Part II entry will be the more legally
compelling one.
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RA: Remittance Advice.
Regenstrief Institute: A research foundation for improving
health care by optimizing the capture, analysis, content, and delivery
of health care information. Regenstrief maintains the LOINC
coding system that is being considered for use as part of the HIPAA
claim attachments standard.
Relates to the Privacy of Individually Identifiable Health Information:
See Part II, 45 CFR 160.202.
Required by Law: See Part II, 45 CFR 164.501.
Research: See Part II, 45 CFR 164.501.
RFA: The Regulatory Flexibility Act.
RVS: Relative Value Scale.
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SC: Subcommittee.
SCHIP: The State Children’s Health Insurance Program.
SDO: Standards Development Organization.
Secretary: Under HIPAA, this refers to the Secretary
of HHS or his/her designated representatives. Also see Part
II, 45 CFR 160.103.
Segment: Under HIPAA, this is a group of related data
elements in a transaction. Also see Part II, 45 CFR 162.103.
Self-Insured: An individual or organization that assumes
the financial risk of paying for health care.
Small Health Plan: Under HIPAA, this is a health plan
with annual receipts of $5 million or less. Also see Part II, 45
CFR 160.103.
SNF: Skilled Nursing Facility.
SNOMED: Systematized Nomenclature of Medicine.
SNIP: See Strategic National Implementation Process.
Sponsor: See Plan Sponsor.
SOW: See Statement of Work.
SSN: Social Security Number.
SSO: See Standard-Setting Organization.
Standard: See Part II, 45 CFR 160.103.
Standard-Setting Organization (SSO): See Part II, 45 CFR
160.103.
Standard Transaction: Under HIPAA, this is a transaction
that complies with the applicable HIPAA standard. Also see
Part II, 45 CFR 162.103.
Standard Transaction Format Compliance System (STFCS): An
EHNAC-sponsored WPC-hosted HIPAA compliance certification service.
State: See Part II, 45 CFR 160.103.
State Law: A constitution, statue, regulation, rule, common
law, or any other State action having the force and effect of law.
Also see Part II, 45 CFR 160.202.
State Uniform Billing Committee (SUBC): A state-specific
affiliate of the NUBC.
Statement of Work (SOW): A document describing the specific
tasks and methodologies that will be followed to satisfy the requirements
of an associated contract or MOU.
STFCS: See the Standard Transaction Format Compliance
System.
Strategic National Implementation Process (SNIP): A WEDI
program for helping the health care industry identify and resolve
HIPAA implementation issues.
Structured Data: See Data-Related Concepts.
SUBC: See State Uniform Billing Committee.
Summary Health Information: See Part II, 45 CFR 164.504.
SWG: Subworkgroup.
Syntax: The rules and conventions that one needs to know
or follow in order to validly record information, or interpret previously
recorded information, for a specific purpose. Thus, a syntax is
a grammar. Such rules and conventions may be either explicit or
implicit. In X12 transactions, the data-element separators, the
sub-element separators, the segment terminators, the segment identifiers,
the loops, the loop identifiers (when present), the repetition factors,
etc., are all aspects of the X12 syntax. When explicit, such syntactical
elements tend to be the structural, or format-related, data elements
that are not required when a direct data entry architecture
is used. Ultimately, though, there is not a perfectly clear division
between the syntactical elements and the business data content.
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TAG: Technical Advisory Group.
TG: Task Group.
Third Party Administrator (TPA): An entity that processes
health care claims and performs related business functions for a
health plan.
TPA: See Third Party Administrator or Trading
Partner Agreement.
TPO: Treatment, Payment, and Operations.
Trading Partner Agreement (TPA): See Part II, 45 CFR 160.103.
Transaction: Under HIPAA, this is the exchange of information
between two parties to carry out financial or administrative activities
related to health care. Also see Part II, 45 CFR 160.103.
Transaction Change Request System: A system established
under HIPAA for accepting and tracking change requests for any of
the HIPAA mandated transactions standards via a single web site.
See www.hipaa-dsmo.org.
Translator: See EDI Translator.
Treatment: See Part II, 45 CFR 164.501.
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