Module 1: COMMON E3D
Application Support
Diagnosis Codes Application
- Indicative Section
- Diagnosis Codes Effective and Termination Dates
- User Warning Messages Section
Place of Service Description, Medical Application
- Indicative Section
Procedure Codes Application
- Indicative Section
Revenue Codes Application
- Indicative Section
User-Defined Codes Application
- Indicative
Explanation Codes Application
- Explanation Section
Subscriber/Family
Parent Group Application
Group Application
- Indicative Section
- Address Section
- Billing/Cap Info Section
- Class/Plan Section
- Related Entities Section
- Policy Information Section
- Rate Data Section
Subgroups Section
- Claims Pay Hold Section
- Incoming Accumulators Section
- Contacts Section
- Notes Section
- Attachments Section
- TCS Letters
- Subgroup Application
- Indicative Section
- Address Section
- Class Section
Subscriber/Family Application
- Subscriber Section
- Members Section
- Addresses Section
- Subgroups Section
- Class Section
- Eligibility Section
- Eligibility Inquiry Section
- Payment Information Section
- Auto Actions Button/Section
- Fam. Accum. Ptr Section
- User Warning Messages Section
- Members Section
- Medicaid Section Tab
- Provider Relationship Section Tab
Enrollment Application
- Subscriber Section
- Modeling
- Member Section
Plan
Plan Descriptions Application
- Indicative Section
Product Application
- Indicative Section
- Business Info Section
- Component Descriptions Application (Application Support Application Group)
Product Application
- Components Section
- Variable Components Section
Product Components
- Administrative Information Application (AIAI)
- Automatic Action Criteria Application (MCRD)
- Automatic PCP Assignment Application/MCPA
- Benefit Summary Descriptions Application
- (Application Support Application Group)
- Benefit Summary Application (BSBS)
- Coordination of Benefits (COB) Rules Application (CBCB)
- Duplicate Claim Rules, Medical Application (DUMD)
- Indicative Section / Indicative Section Tab
- Explanation of Benefits (EOB) Information Application (EBCL)
- Processing Control Agent Application (PCAG)
- User Warning Message Descriptions Application
- User Warning Messages Application (WMUD)
- Warning Messages Application (WMWM)
Service Conversion
- Service Code Conversion
- TOS Codes
Class/Plan Definition Application
- Indicative Section
Service ID Descriptions Application (SEDS)
- Indicative Section
Service/Procedure Conversion Application (TPCT)
- Indicative Section
- Matching Criteria
- Service/Procedure Conversion and Service/Revenue Code Conversion
- Linking procedure codes in the Service/Procedure Conversion application
Service/Revenue Code Conversion Application (RCCT)
- Indicative Section
- Supplemental Revenue Code Conversion Application (SRCT)
- Indicative Section
Supplemental Conversion Qualifier Group Application (SCQG)
- Indicative Section
Supplemental Procedure Conversion Rules Application (SPCR)
- Indicative Section
Supplemental Revenue Conversion Rules Application (SRCR)
- Service Conversion Hierarchy
Service Pricing
- Service ID Descriptions Application (SEDS)
R&C/Schedule, Medical Application (IPRS)
- Indicative Section
Service Pricing Application (SEPC)
- Indicative Section
Service Definition Application (SEDF/AGSE)
- Indicative Section
Deductible Rules
Product Application
- Variable Components Section
Accumulator Descriptions Application
- Deductibles and Limits sections
Deductible Rules Application (DEDE)
- Indicative Section
Service Payment
Service Rule Definition Application (SESE)
- Indicative Section
Service Payment Application (SEPY)
- Indicative Section
Service Related Parameters Application (SERL)
- Indicative Section
- Limit Rules
Limit Rules Application (LTLT)
- Indicative Section
Product Variable Components
Product Application
- Variable Components Section
Eligibility
- Plan Descriptions Application
- Indicative Section
Class/Plan Definition Application (CSPI)
- Indicative Section
Plans Section
- Stop Ages/Waiting Periods Application (GPAI)
- Indicative Section
Subscriber/Class/Eligibility – Membership Structure
Eligibility in the Enrollment Application
Eligibility Inquiry Section
Claims
Facets Claim Flow
Medical Claims Processing Application
- Entering a Medical Claim
- Indicative Section
- Line Items Section
- Medical Claims Processing Section Tabs
- Line Items Section
- Medical Claims Processing Menu Options
- Coordination Of Benefits Dialog Box (COB Button)
- Match UM Reviews Dialog Box (Match UM Button)
- Override (Overrides Button)
- National Drug Code Dialog Box
- Claim Segments
Hospital Claims Processing Application
- Indicative Section
- Hospital Admit / Discharge Date Warnings
- Line Items Section
- Hospital Claims Processing Section Tabs
- Line Items Section
- Claims Inquiry Application
- Medical Section
- Viewing Detailed Claims Information
- EOB/Remittance Section
- Benefit Summary (F6)
- Claim View
- Limit Contributing Claims (Alt+V+L)
- Related Service Accums (Alt+V+R)
- Processed/Translated Codes / Diagnosis or Procedure (Alt+V+P+D/P)
- Claims Inquiry Application
- History Section
- Notes Section
- Payment Reductions Application
- Line of Business Application
- Hospital Claims Processing Application
Claims Processing Application (Claims Level Override)
Provider Application (Payment Info Section)
Member Accumulator Application
Accumulators Section
Family Accumulator Application
Accumulators Section
Provider
Provider Related Entity Application
Common Practitioner Application
- Indicative Section
- Affiliations Section
- Certifications Section
- Professional History Section
- Languages Section
- Malpractice Coverage Section
- Registration Section
- Sanctions Section
- Relationships Section
- Practitioners Section
The Practitioner Application
- Indicative Section
- Addresses Section
- Capitation Sections
- Common Practitioner Section
- Covering Providers Section
- IPAs Section
- Networks Section
- NPI History Section
- Out of Network Section
- Payment Info. Section
- Programs Section
Provider Groups Section
- Referral Provider Section
- Sponsoring Section
- Tax Information Section
- Provider Group Application
- Indicative Section
- Facilities Section
- Practitioners Section
IPA Application
- Indicative Section
Facility Application
- Indicative Section
- Accreditations Section
- Beds Section
- Staff Section
Network/Plan Structure
- Network Application
- Indicative Section
Component Prefix Descriptions Application Indicative Section
Network Set Application (NWST)
- Indicative Section
Network Set (NWST) Structure
- Indicative Section
In-Area Bypass ZIP Code Pricing/Payment Logic
Network Set and Product Variable Components
Product Application
- Variable Components Section
Network/Provider Structure
- Provider Applications
- Networks Section
- Agreement, Medical Application (AGAG)
- Indicative Section
- Related Prefixes
- Service Definition Application (AGSE)???????
- Indicative Section
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