Siebel Healthcare Guide


What's New in This Release


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Overview of Siebel Healthcare

About 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

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)

Updating Company Profiles (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)

Displaying Lists of Investor Transactions or Holdings (End User)


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Managing Contacts

About Managing Contacts

Scenario for Adding a New Contact

Process of Managing Contacts (End User)

Updating or Reviewing a Contact's Holdings

Updating or Reviewing a Contact's Investment Profile

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)

Managing Mortgages (End User)

Performing Mortgage Needs Analyses

Making Mortgage Product Recommendations

Performing Mortgage Prequalifications

Using the Mortgage Calculator


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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

About 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

About 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

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 (Users)

Process of Managing Partners and Agencies (Users)

Adding New Partners

Adding Agents

Adding Information Associated with an Agent


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Referrals and Authorization

About 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

About 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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Siebel Integration Messages

About the Siebel Financial Services Business Platform

Siebel Healthcare Integration Messages

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