Inquiring on the Eligibility of a Member
Recipient Eligibility Verification: An Overview
In this module, you will learn about HIPAA 271 and 272 functions. You will also understand the process to verify recipient eligibility online.
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.
Viewing Admission/MC Enrollment/Eligibility Record History
In this module, you will learn how to view admission history of a member.
Member Services-Siebel: Eligibility, Claims and Third Pary Liability (TPL) Information
In this module you will learn how to retrieve individual eligibility and enrollment information as well as how to view facility and provider receivables information, and more.