Introduction to Claims and Encounters
Introduction to Functionality for PEGA
Explain the funcitionality components of PEGA
Introduction to Provider Reimbursement Information System for Medicaid (PRISM)
Introduction to Provider Reimbursement Information System for Medicaid (PRISM) In this module, you will learn about the benefits, unique features, and functionality of PRISM
Introduction to Mass Resolve Tasks on Suspended Claims
In this module, you will be introduced to the mass resolution function of the Claims and Encounter subsystem. You will also identify the different components of the mass resolution function, such as TCN, errors and error dispositions, and batch processing.
Introduction to Processing Managed Care Payments
In this module, you will be introduced to the Managed Care Payment process. You will also learn about the key concepts in managed care payments, such as capitation, Recoupment, manual payment, and retroactive manual payment.
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.