TALON CSM Role

Confirm Plan Design data feeds are in place and have populated in the Benefit Plan Table. Orient Primary implementation contact on how to impersonate and navigate to see Member Cost Share.

Client Role

Select 5 or more members (see ID of Test Mbrs & Plans) in different Employer groups and on different individual and family Plans who have known adjudicated claims. Impersonate those Members in TALON, shop selected services, and ensure that Your Cost is an accurate reflection of Member Cost share based on that Member's accumulators and the Plan Document.

Process

Impersonate the selected Member, shop a procedure with a known Member Cost Share (per the Plan Document), and confirm Your Cost is correct.

Key Checkpoints

• Health Plan Details reflect accumulators
• Shop a procedure with known Member Cost Share
• When possible, select Provider/Price options that exceed deductible/max OOP thresholds and confirm accurate Your Cost