Plan Descriptions Application
Product Application
- Indicative Section
- Business Info Section
- Component Descriptions Application (Application Support Application Group)
Product Application
- Components Section
- Variable Components Section
Product Components
- Administrative Information Application (AIAI)
- Automatic Action Criteria Application (MCRD)
- Automatic PCP Assignment Application/MCPA
- Benefit Summary Descriptions Application
- (Application Support Application Group)
- Benefit Summary Application (BSBS)
- Coordination of Benefits (COB) Rules Application (CBCB)
- Duplicate Claim Rules, Medical Application (DUMD)
- Indicative Section / Indicative Section Tab
- Explanation of Benefits (EOB) Information Application (EBCL)
- Processing Control Agent Application (PCAG)
- User Warning Message Descriptions Application
- User Warning Messages Application (WMUD)
- Warning Messages Application (WMWM)
Service Conversion
- Service Code Conversion
- TOS Codes
Class/Plan Definition Application
Service ID Descriptions Application (SEDS)
Service/Procedure Conversion Application (TPCT)
- Indicative Section
- Matching Criteria
- Service/Procedure Conversion and Service/Revenue Code Conversion
- Linking procedure codes in the Service/Procedure Conversion application
Service/Revenue Code Conversion Application (RCCT)
- Indicative Section
- Supplemental Revenue Code Conversion Application (SRCT)
- Indicative Section
Supplemental Conversion Qualifier Group Application (SCQG)
Supplemental Procedure Conversion Rules Application (SPCR)
Supplemental Revenue Conversion Rules Application (SRCR)
- Service Conversion Hierarchy
Service Pricing
- Service ID Descriptions Application (SEDS)
R&C/Schedule, Medical Application (IPRS)
Service Pricing Application (SEPC)
Service Definition Application (SEDF/AGSE)
Deductible Rules
Product Application
- Variable Components Section
Accumulator Descriptions Application
- Deductibles and Limits sections
Deductible Rules Application (DEDE)
Service Payment
Service Rule Definition Application (SESE)
Service Payment Application (SEPY)
Service Related Parameters Application (SERL)
Limit Rules
Limit Rules Application (LTLT)
Product Variable Components
Product Application
- Variable Components Section
Eligibility
Plan Descriptions Application
Class/Plan Definition Application (CSPI)
Plans Section
Stop Ages/Waiting Periods Application (GPAI)
Subscriber/Class/Eligibility – Membership Structure
Eligibility in the Enrollment Application
Eligibility Inquiry Section