Medicare Advantage and Prescription Drug Plans December 28 ...

Plan Communications User Guide Appendices, Version 6.3
A: Glossary and List of Abbreviations and Acronyms
Table A-1: Glossary
Term
Accepted Transaction
Account Number
Application Date
Batch Transaction
Beneficiary
Identification Code
(BIC)
Benefit Stabilization
Fund (BSF)
Button
Cancellation
Transaction
Checkbox
Connect:Direct
Correction
Cost Plan
Current Calendar
Month (CCM)
Current Processing
Month
Current Payment Month
(CPM)
Creditable Coverage
Data entry field
Deductible
Disenrollment
Dropdown list
Definition
The successful application of a requested action that was processed by MARx.
A number obtained from the Resource Access Control Facility (RACF) or
system administrator.
The date that the beneficiary applies to enroll in a Plan. Enrollments submitted
by CMS or its contractors, such as the Medicare Beneficiary Contact Center, do
not need application dates.
An automated systems approach to processing in which data items to be
processed must be grouped and processed in bulk.
The portion of the Medicare health insurance claim number that identifies a
specific beneficiary.
Established by CMS upon request of an HMO or CMP, when the HMO or CMP
must provide its Medicare enrollees with additional benefits, to prevent
excessive fluctuation in the provision of those benefits in subsequent contract
periods.
A rectangular icon on a screen which, when clicked, engages an action. The
button is labeled with word(s) that describe the action, such as Find or Update.
A cancellation may result from an action by the beneficiary, CMS, or another
Plan before the effective date of the election. A cancelled enrollment restores
the beneficiary to his/her prior enrollment state.
A field that is part of a group of options, for which the user may select any
number of options. Each option is represented with a small box, where ‘x’
means “on” and an empty box means “off.” When a checkbox is clicked, an ‘x’
appears in the box. When the checkbox is clicked again, the ‘x’ is removed.
The proprietary software that transfers files between systems.
A record submitted by a Plan or CMS office to correct or update existing
Beneficiary data.
A type of contract under which a Plan is reimbursed by CMS for its reasonable
costs.
Represents the calendar month and year at the time of transaction submission.
For batch, the current month is derived from the batch file transmission date; for
User Interface transactions, the current month is derived from the system data at
the time of transaction submission.
The calendar month in which processing occurs to generate payments. The
Current Processing Month is distinguished from the CPM, the month in which
Plans receive payment from CMS.
The month for which Plans receive payment from CMS, not the current calendar
month.
Prescription drug coverage, generally from an employer or union, that is
equivalent to, or better than, Medicare standard prescription drug coverage.
A field that requires the user to enter information.
The amount a Beneficiary must pay for medical services or prescription drugs
before a Plan starts paying benefits.
A record submitted by a Plan, Social Security Administration District Office
(SSA DO), Medicare Customer Service Center (MCSC), or CMS when a
beneficiary discontinues membership in the Plan.
A field that contains a list of values from which the user chooses. Clicking on
the down arrow on the right of the field enables the user to view the list of
values, and then click on a value to select it.
December 28, 2012 A-1 Glossary and List of Abbreviations
and Acronyms