Introduction to Third Party Liability

clturner

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.

Introduction to Managed Care Program Enrollments

clturner

In this module, you will be introduced to the program enrollment process. You will identify the differences between auto enrollments and manual enrollments. You will also learn about the 834 enrollment feature.

Introduction to Member Eligibility

clturner

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.

Introduction to Member Eligibility and Enrollment

clturner

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.

Introduction to Oracle Financials for Medicaid

clturner

This module will describe how Oracle Financials is integrated with PRISM through schedules, batch, and adhoc database to database transfer of financial data. It will also define key functions such as Account Payables, General Ledger, Account Receivables, and Cash Receipts. The module will also list the entities who are involved in Oracle Financials.

Prior Authorization Internal Audit

clturner

In this module you will learn how to:
Create a PA internal audit
Process additional PA audit review
Process the complete training action
PRocess the review completed task