Lay the Groundwork


• Identify your products with tiered networks
• Validate you can identify which providers participate in tiered networks, and at which tier level

SAML Considerations

• The productCode sent in the SAML must align with a product that consists of tiered networks for an authenticated user to see tiers in the UI

Data Requirements


• Validate how tiering will be sent in your data (ProvNetworks or ProductNetwork file)
• Ensure that every provider associated with a tiered networks product has a valid tier number value in the data file
• Send benefits at the tier level in your benefits response for your member out of pocket to reflect values that differ by tier

UI Configuration Requirements

• Complete the Tiered Networks Matrix, identifying the UI display elements for your tiered networks
• The productCode in your provider data must match the productCode in the Tiered Networks Matrix