Reference
Glossary
Terms used in this manual and around the practice.
APA. American Plan Administrators, a commercial payer the practice bills.
APS. Adult Protective Services, Utah’s agency for vulnerable adult abuse reports.
At will. Employment that either party can end at any time, for any lawful reason.
BAA. Business associate agreement. A HIPAA-required contract with any vendor that handles PHI for us.
CAQH. The credentialing database most payers use. Clinicians maintain a profile there.
Care portal. The client-facing system for intake, consents, and documents.
CE / CEU. Continuing education required for license renewal. The practice provides a stipend but is not a CE provider and doesn’t award credit.
Covered entity. A healthcare provider, plan, or clearinghouse that HIPAA applies to directly. The practice is one.
CSW. Certified Social Worker. A Utah license for master’s-level social workers practicing under supervision toward the LCSW.
DCFS. Utah Division of Child and Family Services, where child abuse reports go.
DOPL. Utah Division of Professional Licensing. Issues and regulates clinical licenses.
Duty to warn. The Utah legal duty, under § 78B-3-502, to warn an identifiable victim and notify law enforcement when a client communicates an actual threat of physical violence.
ePHI. Electronic protected health information.
Exempt / non-exempt. Whether an employee is exempt from overtime under federal law. Exempt employees are salaried; non-exempt are hourly with overtime.
FLSA. Fair Labor Standards Act, the federal wage and hour law.
Gusto. The practice’s payroll system.
LCSW. Licensed Clinical Social Worker. Independent clinical license in Utah.
LEIE. The OIG’s List of Excluded Individuals and Entities.
Minimum necessary. The HIPAA principle of using or sharing only the PHI needed for the purpose.
NPI. National Provider Identifier. Every billing clinician has one.
OIG. The HHS Office of Inspector General.
Open item. A policy not yet decided, marked in the manual and listed in Open items.
PCC. Patient Care Coordinator, the front-office role.
PHI. Protected health information. Anything that identifies a client and relates to their care or payment.
PracticeOS. The practice’s configured GoHighLevel workspace: the client record, scheduling, and communication system.
Production bonus. The per-session bonus clinicians earn above a base number of weekly sessions.
PRISM. Utah Medicaid’s provider portal.
Psychotherapy notes. Under HIPAA, a clinician’s separate process notes, which have extra protection. Distinct from the clinical record.
SAM. System for Award Management, the federal exclusion database.
SOP. Standard operating procedure. Step-by-step instructions for a practice process, kept in the SOP library.
Stedi. The clearinghouse the practice uses for eligibility checks and claims.
Superbill. A receipt with the codes a client needs to seek out-of-network reimbursement from their insurance.
Three-color rule. The practice’s rule for what can go into AI tools: Green (freely), Yellow (sanitize first), Red (never).
Touchpoint. The weekly clinical team meeting.
USERRA. The federal law protecting employees who serve in the military.