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A uniform institutional claim form developed by the NUBC that was in general use from 1983 - 1993.

An electronic format of the CMS-1450 paper claim form that has been in general use since 1993.

An organization that developed the initial HCFA-1500 Professional Claim Form. The maintenance responsibilities were later assumed by the NUCC.

The amount added to, or subtracted from, the hospital input price index to yield the PPS update factor.

An international organization dedicated to the elimination or simplification of procedural barriers to international commerce.

An international EDI format. Interactive X12 transactions use the EDIFACT message syntax.

A process by which contract and plan information is updated on HPMS over MDCN and downloaded to the client.

Upload is a process by which the PBP data and ACR spreadsheets are submitted over MDCN to HPMS.

Care that you get for a sudden illness or injury that needs medical care right away, but is not life threatening. Your primary care doctor generally provides urgently needed care if you are in a Medicare health plan other than the Original Medicare Plan. If you are out of your plan's service area for a short time and cannot wait until you return home, the health plan must pay for urgently needed care.

A public-private coalition for reducing health care administrative costs through the standardization and electronic exchange of health care data.

Data that are aggregated by the capitated managed care entity (e.g. the number of primary care visits provided by the plan during the calendar year).