Assessment
Medicaid
In this module, you will learn about HIPAA 271 and 272 functions. You will also understand the process to verify recipient eligibility online.
In this module, you will identify how to access and review member eligibility information in PRISM.
In this module, you will identify the different components of TPL subsystem. You will identify key terms associated with TPL such as, lead, coverage types, payer, and payee.
In this module, you will identify the various types of premium payments available in Utah. You will learn how to process the premium payments.
Assessment
In this module, you will be introduced to the components of Member and Third Party Liability (TPL) subsystems of PRISM. You will identify the functions associated with member eligibility and enrollment. You will also identify the integration of the eligibility and enrollment subsystem with other PRISM subsystems such as Contracts Management, Provider, Claims and Encounters, and Benefits Administration.
In this module, you will be introduced to the member eligibility process. You will learn about the Medicaid program member eligibility and the eRep interface.