Reviewing Provider Program Integrity

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Users will initiate Provider PI case process, and then review and decisions regarding providers based upon varying scenarios.

Viewing Program Expenditures

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This module will first define a program expenditure list, and then use a simulation to explain how to view the program expenditure list.

Approving a Managed Care Program

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The module will first explain the approval process for an MC Program by providing the details of the role that approves MC Programs and the criteria they use. Then it will explain how to approve, reject, and undo the submitting of an MC Program with the help of simulations.

Buyout Program: An Overview

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In this module, you will be introduced to the buyout program. You will come across coverage examples that the buyout program pays for. You will also be introduced to a buyout case and who can be eligible for a buyout program.

Introduction to Managed Care Program Enrollments

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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.