Title: JLN Process - Claims processing  
Owner: Uwe Wahser
Creator: Uwe Wahser May 03, 2019
Last Changed by: Marco Kalin Dec 21, 2022
Tiny Link: (useful for email) https://openimis.atlassian.net/wiki/x/BQAyM
Export As: Word · PDF  
openIMIS base de connaissances (33)
    Page: Accord prestations de soins
    Page: Assurance maladie
    Page: Autorisation préalable
    Page: Barème tarifaire
    Page: Bénéficiaire
    Page: Certificat d‘assurance
    Page: Copaiement
    Page: Demande de prise en charge
    Page: Ensemble d’avantages sociaux
    Page: Examen de la demande
    Page: Explication des prestations (EOB)
    Page: Franchise
    Page: Fraude
    Page: Identificateur du Prestataire
    Page: Lots
    Page: Médecin traitant
    Page: Médecine générale
    Page: Ordonnance
    Page: Patient
    Page: Prestataire
    Page: Prestation
    Page: Prestation d'assurance
    Page: Rapidité d'exécution
    Page: Refus de prise en charge
    Page: Rejetée
    Page: Reste à charge
    Page: Retours
    Page: Régime d'avantages sociaux
    Page: Statuer (sur une demande)
    Page: Traitement des demandes de prestations
    Page: Traitée
    Page: Verifiée
    Page: Évaluée
openIMIS (5)
    Page: 3. User acceptance test/Business process test
    Page: Claim module scope
    Page: JLN Group - Claims Management
    Page: JLN Process - OpenIMIS Mapping
    Page: The JLN Process Matrix
openIMIS Knowledge Base (26)
    Page: Adjudication
    Page: Batch
    Page: Beneficiary
    Page: Benefit
    Page: Benefit Plan
    Page: Benefits Package
    Page: Checked
    Page: Claim
    Page: Claim review
    Page: Claims Processing
    Page: Copayment
    Page: Deductibles
    Page: Denial of a Claim
    Page: Eligibility
    Page: Entered
    Page: Explanation of Benefits (EOB)
    Page: Fee Schedule
    Page: Feedback
    Page: Fraud
    Page: Insuree
    Page: Processed
    Page: Provider
    Page: Provider Identifier
    Page: Rejected
    Page: Timeliness
    Page: Valuated
Labels
There are no labels assigned to this page.
Time Editor  
Dec 21, 2022 16:39 Marco Kalin View Changes
Dec 21, 2022 16:39 Marco Kalin View Changes
Version published after converting to the new editor
Dec 21, 2022 16:39 Marco Kalin View Changes
Feb 18, 2020 13:42 tabea.boateng View Changes
Feb 18, 2020 10:05 arguet_cec  
Outgoing Links
External Links (5)
    www.jointlearningnetwork.org/technical-initiatives/informat…
    www.jointlearningnetwork.org/health-insurance-glossary/#pro…
    www.jointlearningnetwork.org/health-insurance-glossary/#cla…
    www.jointlearningnetwork.org/health-insurance-glossary/#cla…
    https://openimis.atlassian.net/wiki/spaces/OP/pages/8076985…
openIMIS (1)     Page: JLN Process - Claims processing
openIMIS Knowledge Base (19)     Page: Fee Schedule
    Page: Co-Insurance
    Page: Timeliness
    Page: Provider
    Page: Deductibles
    Page: Pre-Authorization
    Page: Claim
    Page: Beneficiary
    Page: Eligibility
    Page: Provider Identifier
    Page: Explanation of Benefits (EOB)
    Page: Adjudication
    Page: Benefit
    Page: Benefit Plan
    Page: Batch
    Page: Copayment
    Page: Fraud
    Page: Denial of a Claim
    Page: Claims Processing