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REVISED: 02/01/2006
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ACQ |
Acquisition |
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A/R |
Applicant/Recipient |
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BC/BS |
Blue Cross/Blue Shield |
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BENDEX |
Beneficiary Data Exchange |
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CAP |
Community Alternative Program |
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CAP/AIDS |
CAP for Auto Immune Deficiency Syndrome Patients |
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CAP/C |
CAP for Medically Fragile Children |
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CAP/DA |
CAP for Disabled Adults |
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CAP/MR-DD |
CAP for Mentally Retarded-Developmentally Disabled |
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COLA |
Cost of Living Adjustment |
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DAC |
Disabled Adult Child |
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DHHS |
Department of Health and Human Services |
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DHHS-1000 |
Authorization to Disclose Health Information (HIPAA Form) |
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DMA |
Division of Medical Assistance |
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DOA |
Date of Application |
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DOB |
Date of Birth |
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DOS |
Date of Service |
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DSB |
Division of Services for the Blind |
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DSB-0511 |
Pharmacy Billing Form |
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DSB-0950 |
Verification of Item Received |
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DSB-2001 |
Application for Eye Care Certification |
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DSB-2007 |
Evaluation with Closed Circuit Television |
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DSB-2032 |
Letter regarding incomplete application |
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DSB-2033 |
Notification of Eligibility Status |
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DSB-2202 |
Report on Eye Examination |
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DSB-2205 |
Referral for Low Vision Screening/Health Counseling |
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DSB-2207 |
Vision Screening List |
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DSB-2218 |
Permission Form for Vision Screening at Day Care |
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DSB-2220 |
Report on Vision Screening of Child at Day Care |
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DSB-4020 |
Pharmacy Agreement |
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DSB-7219 |
Application for Conference |
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DSS (County) |
Department of Social Services |
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DSS (State) |
Division of Social Services (also referred to as NCDSS) |
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ES |
Eligibility Specialist |
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EDS |
Electronic Data System |
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EIS |
Eligibility Information System |
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EOB |
Explanation of Benefits |
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ESC |
Employment Security Commission |
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ESC/UI |
Employment Security Commission/Unemployment Insurance |
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ABBREVIATIONS/ACRONYMS/FORM TITLES |
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Federal IRS/TIN # |
Tax Number |
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Form 372-118 |
Medicaid Request for Prior Approval |
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FY |
Fiscal Year |
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GS |
General Statutes |
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HCFA-1500 |
Form used by certain providers such as physicians to submit Medicaid and Medical Eye Care Program Claims. |
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HIPAA |
Health Insurance Portability and Accountability Act |
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HMO |
Health Maintenance organization |
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ICD-9-CM |
International Classification of Diseases, 9th Revision, Clinical Modification |
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ICN |
Internal control number assigned to a claim by EDS |
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ILR |
Independent Living Rehabilitation |
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ILS |
Independent Living Services |
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IMC |
Income Maintenance Caseworker |
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INS |
Immigration and Naturalization Service (now the Bureau Of Citizenship & Immigration Services of the Department of Homeland Security |
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IRA |
Individual Retirement Account |
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I&R |
Information and Referral |
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IRS |
Internal Revenue Service |
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I-94 |
When temporary I-551 stamp affixed, proves not illegal alien. |
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I-551 |
Permanent Resident Card “Green Card” proves legal status |
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IV-D |
Child Support Enforcement |
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LVA |
Low Vision Aid |
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M-AA |
Medical Assistance to the Aged |
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M-AB |
Medical Assistance to the Blind |
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M-AD |
Medical Assistance to the Disabled |
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MA |
Medical Assistance |
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M.D. |
Doctor of Medicine |
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MEC |
Medical Eye Care |
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MID |
Medicaid Identification Number |
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MPW |
Medicaid for Pregnant Women |
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MR |
Mentally Retarded |
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MQB |
Medicare Qualified Beneficiary |
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N/A |
Not Applicable |
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NECC |
Nursing Eye Care Consultant |
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NCAC |
North Carolina Administrative Code |
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NDC # |
National Drug Code Number |
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NCDSS |
(State) Division of Social Services |
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NCGS |
North Carolina General Statutes |
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OAH |
Office of Administrative Hearings |
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OD |
Right Eye |
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O.D. |
Doctor of Optometry |
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O&M |
Orientation and Mobility |
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QMB |
see MQB |
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OS |
Left Eye |
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ABBREVIATIONS/ACRONYMS/FORM TITLES |
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POA |
Power of Attorney |
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RA |
(Remittance Advice) refers to Medicaid Remittance and Status Report |
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REOMB |
Recipient Explanation of Medicaid Benefits form |
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RP |
Retinitis Pigmentosa |
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RR |
Railroad Retirement |
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RSDI |
Retirement, Survivors, Disability Insurance |
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Rx |
Medical prescription |
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SAVE |
Systematic Alien Verification for Entitlement Programs |
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SDX |
State Data Exchange |
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SFY |
State Fiscal Year |
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SSA |
Social Security Administration |
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SSI |
Supplemental Security Income |
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SSN |
Social Security Number |
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SWB |
Social Worker for the Blind |
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T/C |
Telephone Call |
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TANF |
Temporary Assistance for Needy Families (called Work First Family Assistance or WFFA in N.C.) |
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UI |
Unemployment Insurance |
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UV-400 |
Ultra Violet protective lens |
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VA |
Veterans Administration |
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VR |
Vocational Rehabilitation, Division of |
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WFFA |
Work First Family Assistance (Nationally known as TANF) |
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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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For questions or clarification on any of the policy contained in these manuals, please contact the local district office. |