This product provides prenatal services to unborn children of pregnant, low-income women who do not qualify for Medicaid.
What is CHIP Perinate?
This dept is responsible for provider education, issue resolution, provider satisfaction, relationship development, and regional network awareness.
Who is Account Management
This provider status means that credentialing is still pending, however, claims will still pay as PAR.
What is PS CF?
This system is a cloud-based contract management system that systematically & efficiently manages contract creation, execution, and analysis.
What is Icertis?
This Amisys screen can be used to look up a benefit package to review the Riders that are beneath it.
What is the BE0300 screen?
This product provides health insurance for children with disabilities, special needs, or chronic conditions, who are age 20 or younger.
What is STAR Kids?
This dept ensures provider and ancillary contracts are completed and executed for network participation.
Who is Contract Management?
What is the PR0220 screen?
This section of a contract is used to obtain specific reimbursement amounts/percentages.
What is the Compensation Schedule?
This Amisys screen can be used to review Riders.
What is the BE0250 screen?
This program is for members who are eligible for Medicare or both Medicare and Medicaid (dual eligible).
What is Wellcare by Allwell (Medicare Advantage)
This dept manages reviewing, verifying, and validating a provider's information with state licensing agencies and the National Practitioner Data Bank.
Who is Credentialing?
This EX Code is applied when 2 affiliations have the same TIN and NPI both qualifying for a claim.
What is EXYA?
This system is used by PDM to update provider setups, and it will cross over into the Amisys system.
What is Portico?
This Amisys screen can be used to lookup the definition of a Component.
What is the BE0200 screen?
This program enrolls as an online shopping mall of healthcare plans, and provides affordable healthcare coverage for individuals and families.
What is Ambetter from Superior HealthPlan (Marketplace)
This dept manages all facility, physician, and group data for each of Superior HealthPlan's products, maintaining demographics, payclasses, and billing data.
Who is Provider Data Management (PDM)?
This EX Code is applied to a claim when there are 2 Amisys IDs with the same NPI and TIN both qualifying for a claim.
What is EXYW?
Texas Medicaid configuration of a contract is completed in this system that was developed only for Superior HealthPlan.
What is Honey Badger?
Some benefit config requires this job to run before the configuration takes effect, and claims attempting to adjudicate will pend EXB4 while running.
What is the BER0400 (BP Explode) job?
This program services children and youth in foster care in all 254 counties in Texas.
What is STAR Health Foster Care Plan
This dept can assist with claim rejections from electronic submissions, paper claim rejections per letters, and raw claims data requests.
Who is EDI Services?
This EX Code will apply to a claim if a provider cannot be found at all in Amisys.
When a provider/group has exceptions to timely filing, we can look at this to validate the exception.
What is the contract?
Amisys uses these to represent larger groups of codes.
What are ## groupings?