Glossary

ACN

Attachment Control Number.

AD

Admitting.

ANSI

American National Standards Institute.

API

Change Healthcare APIs for the next generation of healthcare applications!

  • Medical Network Eligibility V3 API: Provides complete patient profile and benefits information to support for delivering healthcare with more efficient and accurate reimbursement.
  • Care Cost Estimator API: Out-Of-Pocket Estimation API service used for both Estimation and Accumulation of Benefits.
  • Vaccination Data Intake Service API: Gives immunization providers and authorized users a simple way to add data to the Vaccination Record Service and issue certified vaccination credentials.
    The Vaccination Data Intake API is a companion to the Vaccination Credential Sharing API and Vaccination Credential Verification API for secure sharing and verification of the vaccination record.
  • Vaccination Credential Sharing and Verification APIs: Are Vaccination Credential Initiative, and allow authorized client applications to request and verify immunization credentials in the form of 'Smart Health Cards' from the Change Healthcare Vaccination Record solution.
  • Professional Claims API and the Institutional Claims API:
    • Allow healthcare providers and institutions to submit healthcare claims for a service or encounter.
  • Claims Status API: Used by the submitter of a medical claim to determine the status of any previously submitted Institutional or Professional claim.

BI

Billing

CMS

Centers for Medicare and Medicaid.

CI

Commercial Insurance.

ControlNumber

Transaction Set Control Number. This is provided by the submitter. Unique ID used to trace the request.

Dependents

Dependents of the subscriber on the insurance policy.

DMG

Demographic information.

DOB

Date-of-Birth.

DOS

Date-of-Service: date of provider service to the subscriber.

EDI

Electronic data interchange.

ERA

Electronic Remittance Advice.

ESRD

End Stage Renal Disease.

F

G

HCPCS

Healthcare Common Procedure Coding System: defines reference codes for items and services provided in the delivery of healthcare.

HIPAA

Health Insurance Portability and Accountability Act.

Healthcheck

The `/healthcheck` endpoint verifies that the operating status of the Change Healthcare APIs is optimal and the APIs are running and accessible.

  • status: "OK" for successful health check

I

K

L

M

NCCI

National Correct Coding Initiative.

NPI

National Provider ID number for the submitting provider.

O

Pagination

Works with the query parameters size and page. Its maximum size is 1000. Page numbering starts at page 0.

ParCode

An access code required to view any additional information about payers, such as the parStatus in the Payer Finder user interface (UI) and API. Contact support for an access code.

ParStatus

An indication of whether or not a provider agrees to participate in the Medicare program and agrees to always accept the Medicare assignment for services rendered to Medicare beneficiaries.

Payer ID

Unique ID number that is assigned to an insurance company for the purpose of transmitting provider claims electronically.

PHI

Personal health information.

PMI

Personal Medical Information.

QMB

Qualified Medicare Beneficiary.

REST API

Rural FQHC

Rural Health Clinics and Federally Qualified Health Centers.

Subscriber

Medical insurance subscriber.

SDK

A Software Dev Kit lets developers test applications before deploying on the production server.

Token

A hashed alphanumeric representation of sensitive data, such as a authorization token.

Token

A hashed alphanumeric representation of sensitive data, such as a authorization token.

VCI

Vaccination Credential Initiative, a cross-industry consortium that includes Change Healthcare.


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