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Module

Claim navigation in Pega Smart Claims Engine

5 Topics

1 hr 20 mins

 Visible to all users
Advanced Pega Smart Claims Engine for Healthcare 8.6 Healthcare Healthcare and Life Sciences Healthcare Payer English

This module details the claims user interface, describes the components of an Internal Control Number (ICN), reviews claim identifiers, and describes claim and claim line statuses in Pega Smart Claims Engine.

After completing this module, you should be able to:

Navigate the user interface of professional, institutional, and dental claims
Describe the structure of an ICN
Describe the different claim and claim line statuses
Search for claims and configure claims search results

Topics

Anatomy of a claim

30 mins

Internal Control Numbers (ICNs)

10 mins

Claim identifiers

10 mins

Claim and claim line statuses

5 mins

Claims search

15 mins

Module Quiz

10 mins

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