Overriding Member Data: An Overview

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This module will define member date override, explain the purpose of overriding member data, and use an illustration to explain the process of overriding member data.

Managed Care Contracts: An Overview

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This module will explain the purpose of an MC Contract. It will also describe the steps to set up an MC Contract by using an illustration.

Contracts Management Process: An Overview

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This module will provide an overview of the Contract Management process with an illustration. It will also describe the stages in the Contracts Management process. The module will also introduce the entities who are involved in the process.

Claims Resolution: An Overview

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In this module, you will be introduced to the Resolution function of Claims and Encounters. You will also learn about the different concepts such as error types, error dispositions, and release and refer functions that are associated with suspended claims.

Entities Involved in Claims and Encounters: An Overview

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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.