Claim navigation in Pega Smart Claims Engine

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.

Advanced

Healthcare

Healthcare and Life Sciences

Healthcare Payer

English

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