Manage Healthcare Claim

Type: Process
Status: Planned
Industry Sector: Healthcare

Description:

Management of healthcare provider claims submitted to insurers or third-party payers.

Parent Process: Manage Healthcare Revenue Cycle

Subprocesses:

Submit Healthcare Claim

Served by Application(s):

Prior Authorization Management System
Revenue Cycle Management System

Realizes Capabilities:

Healthcare Claims Management
Healthcare Revenue Cycle Management

Uses Information Object(s):

Patient
Procedure Code
Diagnosis
Coverage Eligibility Verification
Prior Authorization

Performed by Role(s):

Revenue Cycle Specialist

Triggers Process(es):

None

Planned Manage Healthcare Revenue Cycle Healthcare Healthcare Claims ManagementHealthcare Revenue Cycle Management Revenue Cycle Specialist

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