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.
Assessment: Accessing Claims Information
Assessment
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.
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 the Claim Spenddown List by a Provider
In this module, you will learn how to access spenddown information on the header and service li ne level of a claim.
Viewing Claim Notes by a Provider
In this module, you will learn how a provider can view the claim notes for a selected claim.
Viewing Claim Notes by a State User
In this module, you will learn how a State user can view the claim notes for a selected claim.
Viewing External Claim Status by a State User
In this module, you will learn how to view TPL information for Professional, Institutional, and Dental claims.
Viewing Claim Enhancement Amounts by a Provider
In this module, you will learn how a State user can view the enhancement amount values for a selected claim.
Viewing Claim Enhancement Amounts by a State User
In this module, you will learn about viewing claim enhancement amounts.