| Table of Contents |
|---|
Process Group
Beneficiary Management
...
Provide accurate and timely indication of whether presenting individual is eligible for health care coverage at this point in time at this location and if specific services to be rendered are covered by the individual’s benefits plan
...
Beneficiary identifier
Provider identifier
Benefits class
Beneficiary accumulator
Demographic criteria
Clinical criteria
...
Time-based eligibility status
Beneficiary accumulators
...
Provider understands the extent to which services rendered are covered by the individual’s health care plan
Individual is informaed of the extent to which services are covered under their health care plan
Task Flow Diagram
...