ServiceXG Basics

Manage Subgroups

Subgroups let you further categorize the members of a group.

Go to: Home > Codes and Criteria > Fund Relationships > Subgroups

Field	Description
Subgroup Information tab
*Subgroup Code	The name of the subgroup.
*Subgroup Name	The subgroup's name.
Group Name	The linked group (see Manage Groups).
COBRA Subgroup	An alternate subgroup for processing COBRA.
*Begin Date	The start date for the subgroup.
End Date	The end date for the subgroup.
HIPAA Benefit Status	Associates your subgroup code with a predefined HIPAA status code for HIPAA transmissions: A—Active (the default). C—COBRA. S—Surviving Insured. T—Tax Equity and Fiscal Responsibility Act (TEFRA). Blank—Your user-defined code transmits in the HIPAA file.
Mailing Address	The address where the mail is delivered. The mailing address also displays on the Contact data tile An area available on a session navigation pane that contains key information related to the session (e.g. provider, member, claim, information).. Country*—Select the country from the list. The country code defaults to USA. Invalid Address—Check box indicating the address isn't valid. Address fields—Enter the address format required by your office. (Your office's standard might be to abbreviate the state rather than spell it out). If you only use two of the three address lines, the address is stored in the 2nd and 3rd boxes (Street Address/P.O. Box, and City, State, Zip). For example, if you enter information in the Apartment, City, State, and Zip, the information from Apartment moves to the Street Address.
Benefit Plan Effective tab
From Date	The benefit plan's begin date.
Thru Date	The benefit plan's end date.
Refno	The refno associated with the from and thru dates.
Benefit Plan Code	The benefit plan code for the eligible subgroup members (see Manage Benefit Plans).
Type	The benefit plan type.
Benefit Plan Description	The benefit plan type description.
Standard Coverage	The standard coverage for the benefit plan.
Coverage Description	The description of the standard coverage.

Add a Subgroup

1. Click .
2. Enter the subgroup code and click .

Subgroup Information tab

3. Enter a name for the subgroup.



4. Select the Group Name.
5. Choose a COBRA Subgroup if applicable.

6. Select the Begin Date and optional End Date.

7. Choose a HIPAA Benefit Status to link to the subgroup.

8. In the Mailing Address section, complete the address fields. The Country Code displays automatically based on a SAC setting, but you can change it if needed.

9. Select the Invalid Address check box to mark the address as invalid.

10. In the Valid Change from Subgroups table, enter the subgroups from which a member can transfer.

    • Click .

    • Enter or search for the subgroup. The description of the subgroup displays automatically.

    • Add as many subgroups as you need.

    • To delete a subgroup you added, select the row and click .

11. Click to save.

Benefit Plan Effective tab

12. Select the Benefit Plan Effective tab to add benefit plan information for the subgroup.



13. In the Benefit Plan Effective Dates table, enter the benefit plan's effective dates.
    • Click and select the From Date and Thru Date. The From Date defaults to the subgroup's Begin Date. Note that the plan effective dates must be within the subgroup's effective dates.
    • Click to update the table. A refno is automatically assigned to the from and thru dates.

    

    • Add as many effective date ranges as needed. These dates can't overlap.

    • If you need to delete an effective date range you added, select the row and click .

    • Click to save.

14. To copy a range of effective dates, select the row and click . The copied row of effective dates displays in the table. Copying the effective also copies the benefit plan information in the Detail View table.

15. Edit the From and Thru Dates. Note that these dates can't overlap.

16. After verifying the information, click to update the table and to save.



17. In the Detail View table, add the benefit plan information.

    • Click .

    • Enter the Benefit Plan Code. The benefit plan's Type and Benefit Plan Description displays automatically.

    • Choose the Standard Coverage. The Coverage Description displays.

    • Before linking a coverage code within a subgroup, first link the coverage code to the benefit plan (see Manage Benefit Plans).

    • Click to update the table.

    • Add as many benefit plan codes as needed.

    • If you need to delete a benefit plan code you added, select the row and click .

    • Click to save.

    

Edit a Subgroup

1. Select the subgroup to edit from the Subgroup dropdown list.



2. Edit the information on the Subgroup Information or Benefit Plan Effective tabs.



3. Click to save.

Copy a Subgroup

1. Select the subgroup to copy from the Subgroup dropdown list.
2. Click .
3. Enter a new Subgroup Code and Name and click .



4. The copied subgroups displays with the same information as the original subgroup.



5. Edit the details of the copied subgroup as necessary and click to save.

Delete a Subgroup

1. Select the subgroup to delete from the Subgroup dropdown list.
2. Click .
3. At the message, click to delete the subgroup or to return to the Subgroups screen.



4. If you selected , the subgroup is deleted from the list.

SEE ALSO