Claims & Accumulators

Confirm that Claims have been ingested and accumulators applied accurately.

TALON CSM Role

Orient Primary implementation contact how to impersonate, confirm accumulator amounts on a Member home screen, and navigate to Claims.

Client Role

Select 5 or more members and dependents (see ID of Test Mbrs & Plans) in different Employer groups and on different individual and family Plans who have known adjudicated claims in the adjudication system. Impersonate those Members in TALON and ensure that claims are visible and accumulated Deductible and Out of Pocket are correct. Note that adult dependent claims are blinded to Employees by default.

Process

Process screenshot

Impersonate the selected Member, view plan details with accumulators, and navigate to Claims.