Sharing Data with Partners

Chapter 8, "Sharing Data with Partners," discusses how to share transactional data and master data with your partners.

This chapter includes examples of typical ways that you might share transactional data such as opportunities, service requests, and contacts. Most of the types of transactional data described in this chapter does not apply to your work with the Siebel Group Portal.

The most important types of data you share using the Groups Portal are covered in the following topics:

"Sharing Group Policies with the Employer Groups"
"Sharing Information About Facilities"
"Viewing Information About Group Members"
"Viewing Information About Providers"
"Facility Locator and Provider Locator"

Sharing Group Policies with the Employer Groups

You must always assign the employer group its own policy and no other policies.

When you assign a group policy to the employer group, the employee administrator at the group is able to view or update information about the policy and its line items and about the following information associated with the policy in the following views:

Activities
Census
Employee Classes
Plan Design
Eligible Members
Enrollment
Member Beneficiary
Notes
Pay Plan
Bill To
Service Request
Pay Plan - Bill To

By default, users of the Group Portal can update the data in all of these views. Depending on your business model, you might want to configure the product using Siebel Tools to make some of these views read-only for users of the Group Portal. For example, you might want to make plan design information read-only for Group Portal users. For more information about using Siebel Tools, see Using Siebel Tools.

You can assign group policies to employer group administrators manually, or you can set up Siebel Business Process Designer to assign them automatically. For more information about Siebel Business Process Designer, see Siebel Business Process Framework: Workflow Guide. For more information about group policies, see Siebel Healthcare Guide or Siebel Insurance Guide.

To assign a group policy to an employer group administrator

Navigate to the Group Policy screen.
In the Policies/Quotes list, select the policy you want to assign to the employer group administrator.
In the More Info form, in the Team field, click the select icon.

The Team Members dialog box appears.
In the Team Members dialog box, click New.
In the Team Members list, select the group administrator you want to assign the policy to, and click OK.
In the Team Members dialog box, click OK.

The employee you selected can view the policy in the My Group Policies view of the Group Portal.

Sharing Information About Facilities

Facilities are healthcare organizations that are paid by, or file claims with, your health plan or health insurance company. Examples of facilities are hospitals, clinics, and pharmacies. Facilities are also referred to as provider organizations.

Users at the insurance company can enter information about facilities, or providers can enter this information themselves using the Provider Portal. For more information about entering and maintaining information about facilities, see the chapter about facilities in Siebel Healthcare Guide.

After this information has been entered, you can share it with employer groups, so they can view information about the facilities that are available to them using the Facilities screen of the Group Portal:

You can share a facility with an employee at a group company, and this employee is able to view it in the My Facilities view of the Facilities screen of the Group Portal.
You can also share a facility with a group company, and this company is able to view the member in the All Facilities view of the Facilities screen of the Group Portal, but it is not visible in the My Facilities view for any employee at the group company. Someone at the group company who has access to the All Facilities view can use the Contact Team field to assign the member to specific employees at the group company.

To share information about a facility with a group employee

Navigate to the Facilities screen.
In the Facilities list, select the facility you want to share with a group.
In the More Info form, click the Show More button.
In the More Info form, in the Contact Team field, click the Multiple Select button.
In the Coverage Team dialog box, click New.
In the Add Employees dialog box, select the group employee you want to share the Facility with, and click OK.
In the Coverage Team dialog box, click OK.

This facility is visible to this group employee in the My Facilities view.

To share information about a facility with a group company

N avigate to the Facilities screen.
In the Facilities list, select the facility you want to share with a group.
In the More Info form, click the Show More button.
In the More Info form, in the Organization field, click the Multiple Select button.
In the Organizations dialog box, click New.
In the Add Organizations dialog box, select the Organization for the group you want to share the Facility with, and click OK.
In the Organizations dialog box, click OK.

This facility is visible to this group organization in the All Facilities view.

Viewing Information About Group Members

Members are individuals who are insured by a carrier. In some situations, members are also known as policyholders, subscribers, or insureds.

The Group Portal allows you to reduce the work you do to enter and maintain information about members. The group can enter this information in the Members screen of the Group Portal, and then you can view it in the Members screen of the Partner Manager or of Siebel Healthcare. For more information about entering and maintaining information about members, see the chapter about members in Siebel Healthcare Guide.

To view information about a member

Navigate to the Members screen.
In the Members list, select the member you want to view information about.
Click the view tabs to display more information associated with that member.

Viewing Information About Providers

The Providers screen allows insurance carriers to view and manage information about providers. Providers are healthcare professionals who are paid by, or file claims with, your health plan or health insurance company. Examples of providers are physicians, nurse practitioners, dentists, and pharmacists. For more information about using the Providers screen, see the chapter about providers in Siebel Healthcare Guide.

After information about providers has been entered, you can share it with employer groups, so they can view information about the providers that are available to them using the Providers screen of the Group Portal. Share provider information with a group administrator at a group company, and this administrator is able to view it in the My Providers view of the Providers screen of the Group Portal.

To share information about a provider with an employer group

Navigate to the Providers screen.
In the Providers list, select the provider you want to share with a group.
In the More Info form, click the Show More button.
In the More Info form, in the Contact Team field, click the Multiple Select button.
In the Coverage Team dialog box, click New.
In the Add Employees dialog box, select the group employee you want to share the Provider with, and click OK.
In the Coverage Team dialog box, click OK.

This provider is visible to this group employee in the My Providers view.

Facility Locator and Provider Locator

Employer groups can use the Group Portal's Health Facility Locator and Provider Locator to search for health facilities and providers that are near to them.

Before these locators can be used, the health plan or insurance company must add addresses for the provider locator and add facilities to the facility locator. For more information, see the topics about adding addresses for the provider locator and about adding facilities to the facility locator in Siebel Healthcare Guide.