In this module, you will learn how to view spenddown matching claims data of a member.
Member Demographic Details: An Overview
In this module, you will identify demographic details of a member accessible in PRISM. You will also identify the reasons to add demographic details of a member in PRISM.
Viewing Cost Share Details
In this module, you will learn how to view the cost share details of a member and how to view the five percent cost share data of a member.
Accessing Spenddown Details: An Overview
In this module, you will learn about spenddown data. You will also learn about the matching claims process and the spenddown data process.
Searching the Eligibility Details of a Member
In this module, you will learn how to search the Medicaid eligibility of a member. You will also identify various filter types and key functions available in the eligibility list page.
Viewing Eligibility Details of a Member
In this module, you will learn how to view the eligibility details of an enrolled member. These eligibility details include relationship details, benefit plan history, eligibility history, patient pay amount history, restriction details, third party liability details, and RAC details.
Cost Share: An Overview
In this module, you will learn about cost share data and five percent cost share data.