Glossary Main > Medical Insurance glossary
Medical Insurance Terms
Electronic Media Claim (EMC)
This term usually refers to a flat file format used to transmit or transport claims, such as the 192-byte UB-92 Institutional EMC format and the 320-byte Professional EMC NSF.
National Standard Format (NSF)
Generically, this applies to any nationally standardized data format, but it is often used in a more limited way to designate the Professional EMC NSF, a 320-byte flat file record format used to submit professional claims.
Health and Human Services (HHS)
The federal government department that has overall responsibility for implementing HIPAA.
HCFA form (Health Care For All/ Health Care Financing Administration)
The HHS agency responsible for Medicare and parts of Medicaid. HCFA has historically maintained the UB-92 institutional EMC format specifications, the professional EMC NSF specifications, and specifications for various certifications and authorizations used by the Medicare and Medicaid programs. HCFA also maintains the HCPCS medical code set and the Medicare Remittance Advice Remark Codes administrative code set.
Common Procedure Coding System (HCPCS)
Health Care Financing Administration (HCFA) Common Procedure Coding System (HCPCS). Codes HCFA requires when billing services and supplies. HCPCS include CPT codes to describe physician services, as well as codes to describe their services and supplies.
HCFA 100 form
The standardized Medicare claim form required by Medicare for submission of claims to a Medicare carrier and most payors when a provider submits claims for reimbursement. This form is used by health care providers in MD office based settings, and must be used for Medicare MNT claims. NSF/ANSI837 is the electronic claims form that may be used in place of the HCFA 1500 paper claims form.
Health Level Seven (HL7)
Health Care Financing Administration (HCFA) Common Procedure Coding System (HCPCS). Codes HCFA requires when billing services and supplies. HCPCS include CPT codes to describe physician services, as well as codes to describe their services and supplies.
