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Siebel Healthcare Guide
What's New in This Release
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Overview of Siebel Healthcare
Siebel Healthcare Functionality
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Getting Started with Siebel Healthcare
About Applications Administration Tasks
Renaming Siebel Account Objects
Configuring Lists of Values
Configuring Summary Views
Adding Products and Product Lines
About Command Center
Command Center Configuration and Administration
Process of Configuring the Command Center Action Form
Defining the Command Center Business Object
Defining the Command Center Actions
Selecting the Command Center Responsibilities
Example of Configuring the Command Center Action Applet
Creating Global Commands for the Command Line Applet
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Managing Companies
About Managing Companies and Accounts
About Company Hierarchies
Scenario for Managing Company Information
Process of Managing Companies
Administrator Procedures
End-User Procedures
Setting Up Values for Companies
Deleting Company Information
Managing Competitor Information
Verifying Coverage Team Members
Managing the Custom-Defined Relationship Types LOV
Generating Company Hierarchies for Data Aggregation
Default Company Hierarchies
Dynamic Company Hierarchies
Adding Companies and Investors (End User)
Viewing Company Hierarchies in Roll-Up Views (End User)
Creating Company Assessments (End User)
Adding Company Applications (End User)
Adding Company Service Requests (End User)
Managing Company Coverage Teams (End User)
Viewing Company Summaries (End User)
Viewing Company Relationship Hierarchies (End User)
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Managing Contacts
About Managing Contacts
Scenario for Adding a New Contact
Process of Managing Contacts
End-User Procedures
Managing Contact Information (End User)
Adding Contacts
Creating Categories for Contact Information
Creating Notes About Contacts
Managing Contact Referral Information
Creating Customer Assessments (End User)
Setting the Customer Value Icon (End User)
Viewing a Contact Summary (End User)
Viewing Contact Relationship Hierarchies (End User)
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Managing Households
About Managing Households
Scenario for Managing Households
Process of Managing Households
Adding Households
Setting the Household Privacy Option
Associating Contacts with Households
Viewing Household Summaries
Using the Household Relationship Hierarchy
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Managing Call Reports
About Managing Call Reports
Scenario for Managing Call Reports
Process of Managing Call Reports
Administrator Procedures
End-User Procedures
Viewing Call Report Charts
Activating the New Call Report Workflow
Managing Call Report Templates
Adding Call Reports (End User)
Creating Call Report Distribution Lists (End User)
Associating Action Items, Notes, and Attachments with Call Reports (End User)
Setting the Call Report Privacy Flag (End User)
Emailing and Printing Call Reports (End User)
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Facilities
Scenario for Adding a New Healthcare Facility
Administrator Procedures for Facilities
Adding Facilities to the Facility Locator
End-User Procedures for Facilities
Adding Facilities
Associating Providers, Facilities, and Contacts with a Facility
Adding Facility Contracts
Adding Facility Payments
Adding Facility Claims
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Individual Health Policies
Scenario for Health Insurance Quote and Application
Administering Individual Health Policies
Adding Insurance Products and Product Lines
Adding Insurance Rate Bands
End-User Procedures for Individual Health Policies
Providing Individual Health Policy Quotes
Accepting Individual Health Policy Applications
Adding Service Requests to Individual Health Policies
Setting Up Pay Plans for Individual Health Policies
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Managing Group Policies
About Group Policies
Common Policy Views
Scenario for Group Policies
Process of Managing Group Policies
Administrator Procedures
End-User Procedures
Adding Group Insurance Products and Product Lines
Adding Group Insurance Rate Bands
Defining Activity Plan Templates for Group Policies
Defining Proposal Templates for Group Policies
Adding Group Policy Records
Importing Census Information
Adding Census Information in the Group Policies Screen
Adding Employee Classes for Group Policies
Designing Plans for Group Policies
How Enrollment Waiting Periods Affect the Start of Coverage
Reconfiguring Customizable Products in Plan Design
Generating Proposals for Group Policies
Managing Underwriting Information
Adding Eligible Members to Group Policies
Enrolling Members in Group Policies
Adding Beneficiaries to Group Policies
Setting Up Payment Plans for Group Policies
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Members
About Members for Siebel Healthcare
Scenario for Handling Insurance Agent and Member Inquiries
Administrator Procedures for Members
Adding Health Programs
Configuring the Command Center for Common Member Services
End-User Procedures for Members
Editing the Layout of the Members Summary View
Enrolling Members in Health Programs
Example of Using the Command Center for Common Member Services
ID Card Requests
PCP Requests
Claims Inquiries
Changing the Primary Network or IPA for Members
Adding Additional Benefits Coverage for Members
Setting the Member HIPAA Privacy Option
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Managing Partners and Agencies
About Partners and Agencies
Scenario for Working with Partners and Agencies
Process of Managing Partners and Agencies
End-User Procedures
Adding New Partners
Adding Agents
Adding Information Associated with an Agent
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Referrals and Authorization
Scenario for Creating and Authorizing a Referral
Administrator Procedures for Referrals and Authorizations
End-User Procedures For Referrals and Authorizations
Creating Referrals or Authorizations
Associating Actions and Providers to Referral or Authorization Requests
Recording Approval Decisions for Referrals or Authorizations
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Providers
Scenario for Adding and Managing a New Provider
End-User Procedures for Providers
Adding Providers
Adding Addresses for the Provider Locator
Associating Facilities with Providers
Associating Specialties with Providers
Adding Profile Information
Adding Provider Contracts
Viewing Provider Payments and Adding Payments Manually
Adding Provider Claims
Viewing and Printing a Provider Report
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Managing Billing Accounts
About Billing Accounts
Scenario for Billing Accounts
Process of Managing Billing Accounts
End-User Procedures
Creating Billing Account Records
Associating Billing Accounts with Other Records
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Integration
About the Siebel Financial Services Business Platform
Siebel Healthcare Integration Messages
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Business Services for Siebel Financial Services
About a Business Service
About Siebel Financial Services Business Services
VBC Cache and Instance Manager
Caching VBC Overview
Components
Stages of the Caching VBC Process
Caching VBC Configuration
Purging the VBC Cache
Free Format Converter
Data Validation Manager
Business Rule Processor
Process of Defining Business Rule Processes
Creating and Managing Business Rule Processes
Defining Properties for a Business Rule Process
About Business Rule Process Property Types
Defining Procedures for a Business Rule Process
Fine-Tuning the Assignment Statement
Handling Business Rules Processor Errors
Throwing Errors Within a Business Rules Process
Recovering From Errors Within a Business Rules Process
Using BRP Helper Business Services
FINS CAP Buscomp Data Loader Business Service
FINS CAP Buscomp Handler Business Service
Invoking the Business Rule Processor
Using eScript to Invoke the Business Rule Processor
Logging Business Rules Processor Debug Messages
Requirements Manager
About Requirements Manager
Administering Requirements Manager
Creating Record Templates
Creating Requirement Templates
Using Requirements Manager
Creating Record Group Templates
Example of Using Requirements Manager for Record Group Templates
Customer Authentication Manager
Creating Customer Authentication Templates
Defining Customer Authentication Rules
Invoking Customer Authentication Manager
Using the Calculation Manager
Specifying Calculation Rules
Example of Using Embedded eScript for Mortgage Calculation
Invoking Calculation Manager
Using the Customer Expectations Manager
Defining Customer Expectation Manager Rules
Invoking Customer Expectations Manager
Using Data Transfer Utilities (DTU)
About Data Maps
Using Named Parameters in DTU
Calculation Expressions in DTU
Data Transfer Utilities Methods
Considerations for Data Transfer Utilities
Configuring Event-based Commands
Dynamic Enabling of Commands
Automating Approval Processing
Defining Approval Items and Approval Stages
Invoking FINS Approval Item Service from a Workflow
Approving or Declining Approval Stages (End User)
Automating the Display of Disclosure Documents
Setting Up Disclosures
Understanding and Activating Disclosure Workflows
Invoking the Disclosure UI Service Business Service
Viewing Disclosures Associated with Contacts (End User)
SmartScript Integration with Workflow
Example of Integrating SmartScript with Workflow
FINS Web Shopping Service Methods
FINS SmartScript Output Service Methods
Dynamic UI Business Service
Example of Creating a Dynamic Applet with the Dynamic UI Business Service
Displaying Dynamic Applets in a Workflow
Creating a View Template for Dynamic Applets
FINS Application View Navigation
Business Service Methods
Business Service Behaviors
Business Service Administration
Example of FINS Application View Navigation
Upgrade Note
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Siebel Healthcare Reports
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