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► Membership Management

Supplemental Diagnosis Information

SYSTEM.user_supp_diag_info

Assessment

SYSTEM.Assessment_Allergies1
SYSTEM.Assessment_ImmediateFamily
SYSTEM.Assessment_Insurance1
SYSTEM.Assessment_Losses
SYSTEM.Assessment_Main1
SYSTEM.Assessment_Medications1
SYSTEM.Assessment_SA1

► Provider Management

Provider Information

SYSTEM.user_provider_information

► Care Management

Service Authorization

SYSTEM.service_auth_detail
SYSTEM.service_auth_svc

Care Notes and Documentation

SYSTEM.user_care_notes

Authorization Appeal

SYSTEM.user_appeal_auth

Functional Assessment

SYSTEM.user_functional_assessment

Contracting Provider Service Authorization

SYSTEM.service_auth_detail
SYSTEM.service_auth_svc

Funding Source Service Authorization

SYSTEM.service_auth_detail
SYSTEM.service_auth_svc

► Claims Processing

Batch Creation

SYSTEM.batch_current_data

Fast Service Entry

SYSTEM.batch_claim_lvl_core
SYSTEM.batch_clm_svc_detail
SYSTEM.batch_current_data

Claim Processing (CMS 1500)

SYSTEM.batch_claim_lvl_core
SYSTEM.batch_clm_svc_detail
SYSTEM.batch_current_data

Claim Processing with Override (CMS 1500)

SYSTEM.batch_claim_lvl_core
SYSTEM.batch_clm_svc_detail
SYSTEM.batch_current_data

Claim Processing (UB-04)

SYSTEM.batch_claim_lvl_core
SYSTEM.batch_clm_svc_detail
SYSTEM.batch_current_data

Claim Processing with Override (UB-04)

SYSTEM.batch_claim_lvl_core
SYSTEM.batch_clm_svc_detail
SYSTEM.batch_current_data

Close Batch

SYSTEM.batch_claim_lvl_core
SYSTEM.batch_clm_svc_detail
SYSTEM.batch_current_data

Create Voucher

SYSTEM.table_voucher_core

Create EOB

SYSTEM.table_eob_core

Claim Appeal

SYSTEM.user_appeal_claim

837 Health Care Claim Professional

SYSTEM.batch_claim_lvl_core
SYSTEM.batch_clm_svc_detail
SYSTEM.batch_current_data

► System Maintenance

Manual Batch Adjudication

SYSTEM.batch_claim_lvl_core
SYSTEM.batch_clm_svc_detail
SYSTEM.batch_current_data

Retro Claim Adjudication

SYSTEM.retro_claim_adjudications