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Glossary

  1. A

    accreditation
    An evaluative process in which a healthcare organization undergoes an examination of its operating procedures to determine whether the procedures meet designated criteria as defined by the accrediting body, and to ensure that the organization meets a specified level of quality.
    ACD
    See automatic call distributor.
    ACF
    See ambulatory care facility.
    Alpha Prefix
    Three characters preceding the subscriber identification number on Blue Cross Blue Shield ID cards required for routing claims. It identifies the member's Blue Cross Blue Shield Plan or national account.
    ambulatory care facility (ACF)
    A medical care center that provides a wide range of healthcare services, including preventive care, acute care, surgery, and outpatient care, in a centralized facility. Also known as a medical clinic or medical center.
    ancillary services
    Auxiliary or supplemental services, such as diagnostic services, home health services, physical therapy and occupational therapy, used to support diagnosis and treatment of a patient's condition.
    annual and lifetime maximum benefit amounts
    Maximum dollar amounts set by MCOs that limit the total amount the plan must pay for all healthcare services provided to a subscriber per year or in his/her lifetime.
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