Healthcare Data Glossary

Centers for Medicare and Medicaid Services (CMS)

CMS is the federal agency that administers the Medicare program, works with state governments to administer Medicaid, and is responsible for establishing standards for the Healthcare Industry.

Coding

In medicine, coding refers to the translation of medical diagnoses, procedures, and equipment into universally-understood alphanumeric codes.

Electronic Medical Record (EMR)

An EMR is the digitized version of an individual’s health records. It includes a history of interactions between an individual and their healthcare providers, and is used by the healthcare providers to have a holistic view of an individual’s health.

Health Insurance Portability and Accountability Act (HIPAA)

HIPAA is a 1996 Federal Act that sets rules on how personally identifiable medical information is handled by entities in the healthcare field.

National Provider Identifier (NPI)

A unique identifier assigned to a provider by CMS. This number must be used by all healthcare providers and all payers. There are two types of NPIs:

1) Type I NPI

A Type I NPI represents an individual. This can be a doctor, dentist, pharmacist, therapist, among others.

2) Type II NPI

A Type II NPI represents an organization. This can be a hospital, laboratory, home health agency, ambulance company, among others.

Payer

The organization who pays the bill for the healthcare of a covered individual. We typically think of a payer as a commercial insurance company, but it can also be Medicare, Veterans Affairs, Worker’s Compensation, among others.

Taxonomy

A taxonomy is an alphanumeric code that describes the specialty of a provider.