Facets claims processing online training provides a comprehensive and comprehensive pathway for students to see progress after the end of each module. With a team of extremely dedicated and quality lecturers, facets claims processing online training will not only be a place to share knowledge but also to help students get inspired to explore. Step 2: Open Facets Claims Processing application group and scroll down to Dental Claims processing application. Step 3: In the Indicative page of Medical Claims processing application, enter the following data: Subscriber ID and select a member from the drop down menu, Claim Received Date(suppose Jan 25, 2017), Provider ID and Diagnosis code. Facets Claims Processing System Manual victory service facets system tester (front end) service manual facets claims user manual tricia joy compressor parts manual instructor led healthcare domain, facets, qnxt and service manual audi 8e facets claims processing user guide documents. Facets (Trizetto Claims processing system) provides several functionality which is supported under the application group or you can call modules.It helps the organizations to perform their day to day operational work by utilizing any or all of the application groups. Facets is a registered. Back to Internet-Only Manuals (IOMs) 100-04 Publication # 100-04. Medicare Claims Processing Manual. Processing Hospice Claims (PDF) Chapter 11 Crosswalk (PDF).
Project For a National Senior Market Health Insurer
CHALLENGE
The executives of a national Medicare Advantage health plan wanted to adopt a common information systems platform for all of its products in the Medicare-eligible population. The health plan had selected the TriZetto-hosted Facets product as the core claims processing system. The Facets application was already supporting the plan’s Preferred Provider Organization (PPO) and Private Fee-for-Service (PFFS) products; the health plan needed to migrate their HMO product to Facets from the EZ-CAP system to create a single, enterprise-wide information solution.
Facets Claims Processing System
Facets Claims Processing Pdf
In order to implement Facets within the HMO product line, the operations leadership of the health plan required functional and technical expertise to work with their end-users and the health plan’s Information Technology (IT) Department.
SERVICES
Advanta staffed the effort with a project manager, who had more than 10 years of Facets implementation experience with a wide range of plan types, along with a project team, throughout the lifecycle. The project manager and the team:
- Elicited and documented business requirements
- Conducted a gap analysis between identified business requirements and system capabilities
- Developed and documented new business processes and workflows to define the “new” operational model
- Developed policies and procedures to support new operational model
- Created desktop and job aides to support future processes and workflows
- Facilitated decision-making around system configuration
- Provided testing support, including user-acceptance testing (UAT)
- Developed and provided staff training on the new operational model and system functionalities
Staffed go-live and post-deployment activities
RESULT
The migration of the HMO business from EZ-CAP to TriZetto Facets was successful and became the foundation for achieving planned operational improvements and cost reductions.