Health care data and information submitted by Health Care Payers to CHIA is not a public record. No public disclosure of any health plan information or data shall be made unless specifically authorized under 114.5 CMR 21.00 or 114.5 CMR 22.00. Acronyms Frequently Used APCD All-Payer Claims Database – CHIA Center for Health Information and Analysis – CSO Computer Services Organization – DBA Delegated Benefit Administrator – DBM Dental Benefit Manager – DOI Division of Insurance – GIC Group Insurance Commission – ID Identification; Identifier – MA APCD Massachusetts’ All-Payer Claims Database – PBM Pharmacy Benefit Manager – QA Quality Assurance – RA Risk Adjustment; Risk Adjuster – TME / RP Total Medical Expense / Relative Pricing – TPA Third Party Administrator – The File Types: DC Dental Claims – MC Medical Claims – ME Member Eligibility – PC Pharmacy Claims – PR Product File – PV Provider File – BP Benefit Plan Control Total File –
Health care data and information submitted by Health Care Payers to CHIA is not a public record. No public disclosure of any health plan information or data shall be made unless specifically authorized under 114.5 CMR 21.00 or 114.5 CMR 22.00. Acronyms Frequently Used APCD – All-Payer Claims Database CHIA – Center for Health Information and Analysis CSO – Computer Services Organization DBA – Delegated Benefit Administrator DBM – Dental Benefit Manager DOI – Division of Insurance GIC – Group Insurance Commission ID – Identification; Identifier MA APCD – Massachusetts’ All-Payer Claims Database PBM – Pharmacy Benefit Manager QA – Quality Assurance RA – Risk Adjustment; Risk Adjuster TME / RP – Total Medical Expense / Relative Pricing TPA – Third Party Administrator The File Types: DC – Dental Claims MC – Medical Claims ME – Member Eligibility PC – Pharmacy Claims PR – Product File PV – Provider File BP – Benefit Plan Control Total File
v3-1-apcd-medical-claim-file-submission-guide-2013-06.docx