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The Claim Lines Tab allows users to view, manage, and take actions on all claims within a specific claim cycle. This tab is essential for validating and processing claims before they move to further stages.
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Upon expanding the review level, there are two sub-categories which are ‘Flagged’ and ‘Not Flagged’. ‘Flagged’ claims will be highlighted in red, they normally will have criteria as listed below:
Flagged Claims Criteria:
Document date, claim amount, or receipt number has been amended.
Duplicate attachments detected across other claims.
Actions Available
There are two primary actions users can perform under this tab:
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Click on a specific claim line to view its details.
In the Claim Line Details panel, click the Approve button on the top-right corner.
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2. Claim On-Hold
If a claim requires further review or clarification, it can be placed on hold.
Steps to Place a Claim On-Hold:
Select the claim line from the list.
Click the On-Hold button in the top-right corner of the panel.
Enter a remark or upload an attachment explaining the reason for the hold.
Click Submit to finalize the action.
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Impact:
Claimants will see the on-hold status along with the remarks or attachments provided.
By utilizing these actions, users ensure all claims are thoroughly reviewed and processed according to organizational standards.
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