WHAT’S NEW

Smart-LinQ has removed its restriction that dis-allows updates to policy Effective Date and Incurred / Paid periods for Spec and Agg once member data has been imported. 

• Clients need the ability to make changes after the fact because:

  • Mistakes in the original configuration

  • Term Information may not be 100% clear until after the policy has begun

  • The client has terminated their Stop Loss contract early because they couldn’t fund their Self Funded Plan as expected.

  • Prior to Agg Support, policies were setup with large Spec Deductibles. TPAs would like to migrate the policies to to used the agg terms and turn off Spec.

WHAT YOU NEED TO KNOW

Now that users are allowed to update the Incurred & Paid Terms at any point in a policy, there will be data ramifications.

Smart-LinQ will no reprocess / interrogate claims for eligibility; keep all claims and flags as they were at the time of the change.  This includes the Spec Eligible Flag and the Agg Eligible Flag. 

As such when terms are updated the client may need to engage Ringmaster Account Services to flip eligibility flags thru scripts or deletion/reimporting of claims.