Group Setup
Subgroup Setup
Class Plan Setup
Billing Entity
Plans
100
This is where the Group Name housed
What is the Group Application, Indicative Section, Name field?
100
This is where the billing address is located which is sometimes different than the physical address of the group.
What is Subgroup Application, Address Section?
100
This is the 4 digit code that is always entered into the Procedure, Renevue and Service Code Conversion Prefix field.
What is 0010?
100
This section will hold the Billing Address if it is different from the Subgroup Address
What is the Address Section?
100
This is the field that is only completed for a plan ID that begins with PPR, HMR, PER or HER.
What is the HRA Admin Info ID field?
200
The only checkbox to be checked in the Group Application, Indicative Section.
What is Auto-Number Subscriber checkbox?
200
This section holds Subgroup factors for Small Groups and Association Groups?
What is the Rate Data Section?
200
This is where you would place B001 if the group had an HSA and the group was "partnering" with Melon Bank.
What is Partner Bank Prefix field?
200
These are the actions that are taken in the menu bar to set up Billing while in the Subgroup Application.
What is Actions/Billing Modeling?
200
These are the three field that are populated for Small Groups that help generate rates.
What are the Rate Guarantee Start, Months and Period fields?
300
Two sections that are display-only in the Group Application
What is Class/Plan and Subgroups Sections?
300
This section holds the SIC code.
What is the Additional Data Section?
300
These are three fields in the Class Plan Information dialog box that are populated for Medical products only
What is the Network Set, Covering Provider Set and IT Alpha Prefix field?
300
This is the choice selected in the Billing Modeling dialog box when the group is a Small Group and the Billing Due Date is 1st of the month.
What is COMM01?
300
This is the ID Card Type used for Fully Insured PPOs, HSA PPOs or MERP PPOs.
What is K100 (Fully Insured)?
400
Today's date is used on this Related Entity
What is Account Specialist (ACSP) Related Entity?
400
These are two possible fields that will hold the Customer Service phone numbers in the Basic ID Card Data Section
What are the Free 2 & Free 3 fields?
400
This the correct selection in the Category field for a Drug plan.
What is "X - Prescription?"
400
This is Premium Statement Print ID that is used for LVC Groups.
What is PBLV?
400
The ID Card Type field is left blank for this product.
What is FSA?
500
This section holds two very different pieces of information. One piece of information is only used when a group has HMO.
What is the Billing/Cap Info Section?
500
This is the field that is completed on the Decision Maker, but is not completed on the Group Administrator
What is the "Title" field?
500
This is the field that is filled out for FSA plans that offer Debit Cards.
What is Debit Card/Bank Relationship Prefix?
500
This is the 4-digit code in the Delinquency Definition field of the Billing Entity Application used for a Small Group non-HMO Subgroup.
What is DELI?
500
This is what is populated in the IT Alpha Prefix field for an HMO product.
What is YWV?
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