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Glossary of Terms and Abbreviations

Abbreviation	Definition
ADV	Annual Dental Visit
ASC	Accredited Standards Committee
APCD-CDL	All Player Claims Database Common Data Layout
APL	Application Program Interface
APL	All Plan Letter
BH	Behavioral Health
BHIN	Behavioral Health Information Notice
BMA	Base Model Average
CAP	Corrective Action Plan
C.A.R.T.	Completeness, Accuracy, Reasonability, Timeliness
CBAS	Community Based Adult Services
CCM	Complex Care Management
CDT	Current Dental Terminology
CGs	Companion Guides
CIN	Client Index Number
CalMHSA	California Mental Health Services Authority
CLR	Closed Loop Referral
CMs	Contract Managers
CMS	Centers for Medicare & Medicaid Services
CoC	Continuity of Care
CPE	Certified Public Expenditure
CPT	Current Procedural Terminology
DAD	Data Analytics Division
DCU	Data Collection Unit
DMC	Dental Managed Care Plans
DMC-ODS	Drug Medi-Cal Organized Delivery Systems
DRMT	Data Reasonability Measure Threshold
D-SNP	Dual-Special Needs Plan
DQRU	Data Quality Reporting Unit
ECM/CS	Enhanced Care Management / Community Supports
ECP	Encounter Completeness Percentage
ED	Encounter Data
EDI	Electronic Data Interchange
EDIM	Enterprise Data and Information Management Division
EDIP	Encounter Data Improvement Program
EDGPA	Encounter Data Grade Point Average
EDSRF	Encounter Data Submission Reconciliation Form
EDQI	Encounter Data Quality Improvement
EDQG	Encounter Data Quality Grade
EPM	Enterprise Performance Monitoring
EVR	Encounter Validation Response
FPACT	Family Planning, Access, Care and Treatment
FQHC	Federally Qualified Health Center
GMA	GME Model Average
GME	Gross Medical Expense
HCAI	Health Care Access and Information
HCP	Health Care Provider
HCPCS	Healthcare Common Procedure Coding System
HIPAA	Health Insurance Portability and Accountability Act
HIMD	Health Information Management Division
HPSA	Health Professional Shortage Areas
IBHPs	Integrated Behavioral Health Plans
IGs	Implementation Guides
IHC	Indian Health Center
IHSS	In-Home Supportive Services
IPA	Independent Physician Associations
LMR	Longitudinal  Member Record
LTC	Long Term Care
JSON	Java Script Object Notation
MCP	Managed Care Plan
MCPAR CI	Managed Care Program Annual Report Critical Incidents
MCPD/PCPA	Managed Care Program Data / Primary Care Provider Assignment
MCPs	Medi-Cal Managed Care Providers
MCAS	Managed Care Accountability Set
MCD	Medi-Cal Dental
MCPD	Managed Care Provider Directory
MCQMD	Managed Care Quality and Monitoring Division
MDC	Monthly Data Checks
MEDS	Medi-Cal Eligibility Data System
MERs	Medical Exemption Requests
MHP	Mental Health Plan
MLTSS	Managed Long Term Services and Supports
MMC	Medicaid Managed Care
MIS/DSS	Management Information System / Decision Support System
MSRP	MCQMD Site Review Portal
MUA	Medically Underserved Areas
NACT	Network Adequacy Certification Tool
NCPDP	The National Council for Prescription Drug Programs
NDC	National Drug Codes
NPI	National Provider Identifier
NPPES	National Plan & Provider Enumeration System
OBA	Outcomes Based Assessment
PACES	Post-Adjudicated Claim and Encounter System
PACE	Programs for All Inclusive Care for the Elderly
PCP	Primary Care Physician
PADs	Physician Administered Drugs
PDF	Plan Data Feed
PDRD	Program Data Reporting Division
PDSRF	Production Data Submission Reconciliation Form
PGDSRF	Program Data Submission Reconciliation Form
PHM KPI	Population Health Management Key Performance Indicators
PNR	Provider Network Report
QIMR	Quarterly Implementation Monitoring Report
QMED	Quality Measures for Encounter Data
QMPR	Quarterly Monitoring Performance Report
QMRT	Quarterly Monitoring Response Template
RDT	Rate Development Template
RHC	Rural Health Clinic
RSST	Risk Stratification Segmentation and Tiering
SCAN	Senior Care Action Network
SCO	State Controller’s Office
SDC	Semi-Annual Data Checks
SDOs	Standard Development Organizations
SDMC	Short Doyle Medi-Cal
SFTP	Secure File Transfer Protocol
SRF	Submission Reconciliation Form
SNCs	Safety Net Clinics
SOGI	Sexual Orientation/Gender Identification
SUME	Supplemental Eligibility
TADT	Timely Access Data Tool
TSC	Telephonic Service Center
T-MSIS	Transformed Medicaid Statistical Information System
TC	Testing Criteria
TFL-CH	Topical Fluoride for Children
TPL	Third Party Administrator
UC-CART	Uniqueness,Consistency,Completeness,Accuracy,Reasonableness,Timeliness
VRF	Validation Response File
WCM	Whole Child Model
WIC	Women, Infants and Children
XSD	XML Schema Definition