In this module, you will be introduced to the different entities involved in claims and encounters. You will also understand the role played by each of the entities in the processing and administration of claims and identify the important user profiles that are associated with these entities.
Introduction to HIPAA Transactions Relating to Claims
In this module, you will be introduced to the outbound and inbound HIPAA transactions that are generated to support the processing of claims and encounters in the Evobrix system. You will also learn about the different types of acknowledgment/responses that are generated as a result of claims processing.
Viewing the Claim Spenddown List by a State User
In this module, you will learn how to view the spenddown information on the header and service line level of a claim.
Assessment: Accessing Claims Information
Assessment
Introduction to Claimsure
In this module, you will be introduced to the components of the Claims and Encounter subsystem of PRISM and identify the role of each of the components in claims processing. You will also identify the adjudication process and learn about the integration of the Claims and Encounter subsystem with other PRISM subsystems such as Contracts Management, Provider, and Benefits Administration.
Claim Types: An Overview
In this module, you will be introduced to the different types of claims and identify the characteristic of each claim type.
Viewing Servicing Facility Locations by a Provider
In this module, you will learn how a provider can view Servicing Facility Locations information for a Professional claim.
Viewing Spinal Manipulation Information by a Provider
In this module, you will learn how a provider can view Claim Spinal Manipulation information for a Professional claim.