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ABBREVIATIONS/ACRONYMS/FORM TITLES

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REVISED: 02/01/2006

 

ACQ

Acquisition

A/R

Applicant/Recipient

BC/BS

Blue Cross/Blue Shield

BENDEX

Beneficiary Data Exchange

CAP

Community Alternative Program

CAP/AIDS

CAP for Auto Immune Deficiency Syndrome Patients

CAP/C

CAP for Medically Fragile Children

CAP/DA

CAP for Disabled Adults

CAP/MR-DD

CAP for Mentally Retarded-Developmentally Disabled

COLA

Cost of Living Adjustment

DAC

Disabled Adult Child

DHHS

Department of Health and Human Services

DHHS-1000

Authorization to Disclose Health Information (HIPAA Form)

DMA

Division of Medical Assistance

DOA

Date of Application

DOB

Date of Birth

DOS

Date of Service

DSB

Division of Services for the Blind

DSB-0511

Pharmacy Billing Form

DSB-0950

Verification of Item Received

DSB-2001

Application for Eye Care Certification

DSB-2007

Evaluation with Closed Circuit Television

DSB-2032

Letter regarding incomplete application

DSB-2033

Notification of Eligibility Status

DSB-2202

Report on Eye Examination

DSB-2205

Referral for Low Vision Screening/Health Counseling

DSB-2207

Vision Screening List

DSB-2218

Permission Form for Vision Screening at Day Care

DSB-2220

Report on Vision Screening of Child at Day Care

DSB-4020

Pharmacy Agreement

DSB-7219

Application for Conference

DSS (County)

Department of Social Services

DSS (State)

Division of Social Services (also referred to as NCDSS)

ES

Eligibility Specialist

EDS

Electronic Data System

EIS

Eligibility Information System

EOB

Explanation of Benefits

ESC

Employment Security Commission

ESC/UI

Employment Security Commission/Unemployment Insurance

ABBREVIATIONS/ACRONYMS/FORM TITLES

Federal IRS/TIN #

Tax Number

Form 372-118

Medicaid Request for Prior Approval

FY

Fiscal Year

GS

General Statutes

HCFA-1500

Form used by certain providers such as physicians to submit Medicaid and Medical Eye Care Program Claims.

HIPAA

Health Insurance Portability and Accountability Act

HMO

Health Maintenance organization

ICD-9-CM

International Classification of Diseases, 9th Revision, Clinical Modification

ICN

Internal control number assigned to a claim by EDS

ILR

Independent Living Rehabilitation

ILS

Independent Living Services

IMC

Income Maintenance Caseworker

INS

Immigration and Naturalization Service (now the Bureau Of Citizenship & Immigration Services of the Department of Homeland Security

IRA

Individual Retirement Account

I&R

Information and Referral

IRS

Internal Revenue Service

I-94

When temporary I-551 stamp affixed, proves not illegal alien.

I-551

Permanent Resident Card “Green Card” proves legal status

IV-D

Child Support Enforcement

LVA

Low Vision Aid

M-AA

Medical Assistance to the Aged

M-AB

Medical Assistance to the Blind

M-AD

Medical Assistance to the Disabled

MA

Medical Assistance

M.D.

Doctor of Medicine

MEC

Medical Eye Care

MID

Medicaid Identification Number

MPW

Medicaid for Pregnant Women

MR

Mentally Retarded

MQB

Medicare Qualified Beneficiary

N/A

Not Applicable

NECC

Nursing Eye Care Consultant

NCAC

North Carolina Administrative Code

NDC #

National Drug Code Number

NCDSS

(State) Division of Social Services

NCGS

North Carolina General Statutes

OAH

Office of Administrative Hearings

OD

Right Eye

O.D.

Doctor of Optometry

O&M

Orientation and Mobility

QMB

see MQB

OS

Left Eye

ABBREVIATIONS/ACRONYMS/FORM TITLES

POA

Power of Attorney

RA

(Remittance Advice) refers to Medicaid Remittance and Status Report

REOMB

Recipient Explanation of Medicaid Benefits form

RP

Retinitis Pigmentosa

RR

Railroad Retirement

RSDI

Retirement, Survivors, Disability Insurance

Rx

Medical prescription

SAVE

Systematic Alien Verification for Entitlement Programs

SDX

State Data Exchange

SFY

State Fiscal Year

SSA

Social Security Administration

SSI

Supplemental Security Income

SSN

Social Security Number

SWB

Social Worker for the Blind

T/C

Telephone Call

TANF

Temporary Assistance for Needy Families (called Work First Family Assistance or WFFA in N.C.)

UI

Unemployment Insurance

UV-400

Ultra Violet protective lens

VA

Veterans Administration

VR

Vocational Rehabilitation, Division of

WFFA

Work First Family Assistance (Nationally known as TANF)

YAG

Yittrium-aluminum-garnet laser

Dictionary of Eye Terminology, Third Edition by Barbara Cassin, Sheila A.B. Solomon and edited by Melvin L. Rubin, MD was used as a resource.

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