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 957 CMR 5.00 Care Claims. Case Mix and –Health Charge Data Release Procedures. 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 – NPI National Provider Identifier – PBM Pharmacy Benefit Manager – QA Quality Assurance – RA Risk Adjustment; Risk Adjuster – TME / RP Medical Expense / Relative Pricing – TPA 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 957 CMR 5.00 –Health Care Claims. Case Mix and Charge Data Release Procedures. 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 NPI – National Provider Identifier PBM – Pharmacy Benefit Manager QA – Quality Assurance RA – Risk Adjustment; Risk Adjuster TME / RP – Medical Expense / Relative Pricing TPA – 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
apcd-provider-file-submission-guide.docx