Centene
The largest Medicaid managed care organization in the US.
Who is Centene?
A department at PSHP which is designed around the concept of making the provider experience with Peach State a positive one by being your advocate within the plan.
What is provider relations?
Intent used to review/dispute questions about claims.
What is Claims Inquiry?
Use this Amisys screen to search for a member.
What is IQ0100 / Member Inquiry?
Source of truth for claims adjudication.
What is Amisys?
Transforming the health of the community,
one person at a time.
What is Centene's Purpose?
Extra services/benefits offered to PSHP eligiblity members, based on certain qualifications.
What are Value Added Benefits/Services?
Intent used to document provider's request to update their information.
What is Provider Outreach?
Use this Amisys screen to search for Providers.
What is IQ0200 / Provider Search?
This system is the source of truth for provider information.
What is Portico?
Better health outcomes at lower costs.
What is Centene's Mission Statement?
A comprehensive health care program for uninsured children living in Georgia.
What is PeachCare for Kids?
This intent is used to request Value Added Benedits, such as YMCA Membership or Girl Scouts.
What is Benefits & Eligibility?
Use this screen to search for detailed claims data.
What is IQ1200 / Claim Summary Inquiry?
This system is the source of truth for medical authorizations and appeals decisions.
What is TruCare Cloud?
Your Centene Intranet.
What is CNET?
What is Planning for Healthy Babies?
This intent is used to send materials to member's as requested.
What is Material Request?
What screen is used to determine if and when a paper check has been cashed?
What is FS0400 / Reconcile Checks?
We use this system to view rejected claims.
What is the ECM Tool?
The system that all Centene employees can search for company policies and procedures.
What is Archer?
A place where members can manage their health benefits, change their primary care provider, contact a plan representative, view claims and more.
What is the Member Portal?
This group will assist with correcting certain claims for the provider services reps.
What is Provider Claims Support (PCS)?
This screen is used to confirm the address where the check or EOP is mailed.
What is RF0600 / Procider Financila Address?
This tool is used to view member rewards and the reward card.
What is My Care Card?