Facets Claims Processing System Manual

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In response to MD HarunRashid's request, I am again giving an example of Dental Claim which is similarto Real Life Scenario. The test case name is Oral Surgery. These are the steps that you are supposed to perform to process a dental claim in Facets under medicalplan.
Facets claims processing system manual pdf

Back to Internet-Only Manuals (IOMs) 100-04 Publication # 100-04. Medicare Claims Processing Manual. Processing Hospice Claims (PDF) Chapter 11 Crosswalk (PDF). Information as the Facets manual, facets.pdf, which is in your Facets folder. Left-click on the next to “Special Topics” to expand the topic list. Then left-click on “Glossary” to display a glossary of Rasch technical words. You may find this useful if you don’t understand the meaning of a word in this Tutorial. 99 saturn sl2 car manual facets claims user manual priority downloads yamaha waverunner 800xlt manual health claims processing in the us - tm floyd & basic elctrical manual facets claims processing and ajudication system adventist pathfinder staff manual facets claims user manual compiled pdf, doc, ppt rand ts1a claims processing system.

Back to Internet-Only Manuals (IOMs) 100-04 Publication # 100-04. Medicare Claims Processing Manual. Chapter 1 - General Billing Requirements (PDF). Processing Hospice Claims (PDF) Chapter 11 Crosswalk (PDF) Chapter 12 - Physicians/Nonphysician Practitioners (PDF). Facets Claims Processing System Manual Average ratng: 5,7/10 5835votes Claims Processing Applications Group. Facets is a modular system. Sierra/Facets 2.81 Training Manual Facets.

Step 1: Open Test Lab Module ofALM, you will see the following test case in test lab module of ALM/QC.
Test Case description:Process a claim for Oral Surgeryservices using following data: INN Provider 333444555777 (Dental Surgeon), POS11, HCPCS D7240, Subscriber ID-100200300, Diagnosis code ICD10: k08499,Charges (PCP's Fee) $350, Unit 1(One Time Visit).
Expected Result: Claim should apply aCopayment of $50 , then process at 80% of the allowable.
Step 2: Open Facets ClaimsProcessing application group and scroll down to Dental Claims processingapplication.
Step 3: In the Indicative pageof Medical Claims processing application, enter the following data: SubscriberID and select a member from the drop down menu, Claim Received Date(suppose Jan25, 2017), Provider ID and Diagnosis code.
Step 4: Now double click onLine Item page and when you are in Line Item page, enter the following data:Date of service (suppose Jan 20, 2017), POS, HCPCS code, Charges(suppose $350),Unit(suppose 1), Total charges(Suppose $350).
Step 5: Press F3 on yourkeyboard to process the claim. Now check the claim pricing.
Step 6: If the claim applies acopayment of $50 as expected and then process at 80% of the allowable, save theclaim by pressing F4 on your keyboard. Facets will generate a claim IDautomatically. Suppose the claim ID is 000011112222
Step7: Open Lab module of ALM,take required screenshots and type as follows in actual result edit box:
ManualClaims
Claim processed asexpected and write the claim ID and pass the test case.

Note: HCPCS stands forHealthcare Common Procedure Coding System.

A large healthcare organization was slowed down by their inability to process claims quickly and accurately. Relying on full-time employees to manually enter information spread across multiple programs resulted in costly processing errors while also taking time away the employee’s core responsibilities.

01 MANUAL WORK

Prior to automation, the worker must take the claims from an excel sheet, and process them into the Facets application, and then save the claims using F3 and F4 keyboard shortcuts

02 PROCESSING

Running the process with the Facets Screen open will trigger the robot to follow the same steps in the same way that a human worker would.

03 COMPLETION

When completed, the process will notify the system that the USER has completed the process, and can therefore end the process.

04 RESULTS

Where it would take a human an average of 2 minutes to process each claim, the robot is only limited by the systems hardware, resulting in 50% time savings.

Facets Claims Processing System

Through a competitive bid process, the client ended up selection one of the leading RPA software vendors to help resolve bottleneck. During set-up and installation, CoSourcing Partners came in and conducted a 5-day operational assessment to create process documents, and a development roadmap.

Facets Claims Processing Training

Over the next 6 weeks, seasoned RPA Developers came on-site and programmed, tested, and put into production a fully automated and unattended Claims Processing Robot.

Facets Claims Processing System Manual Instructions

Since the Robot has entered production, claims processing time has decreased by 50%, while maintaining 100% accuracy. This has led to $2,000,000 in increased revenue of the first 12 months.

Claims

Whether it’s a technology challenge or a resource challenge, we have the answers

Facets Claims Processing Pdf

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