JLN Process - Eligibility inquiry by beneficiary

Process Group

Beneficiary Management

Objective

Provide Indication of whether beneficiary is eligible for health insurance coverage and details on specific services covered by plan benefits

Input

Output

Measurable Outcomes

Beneficiary receives information about services covered by benefits plan, indication of whether benefits cap has been reached and totals for payment/co-payments made to date (beneficiary accumulators)

Sources

 

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