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Insurance
Check Financial Authority in Claim Payment Processes

Check Financial Authority in Claim Payment Processes

As part of your financial authorization workflow, configure the Integration Procedure that's specified for the ClaimInitiatePaymentIP Insurance Configuration Setup custom setting. This is the same Integration Procedure that's kicked off by InsClaimItemService: invokeInitiatePaymentIP.

Insurance Configuration Setup custom setting list with ClaimInitiatePaymentIP highlighted

  1. Add a new Remote Action called FinancialAuthorityCheck or something similar.

    Have it call InsClaimItemService: claimCoverageValuation to verify a user's financial authority.

    Remote Class

    Remote Method

    InsClaimItemService

    claimCoverageValuation

    Add remote options to set the Status of claims, claim coverages, and payment details to Pending Authority if a user doesn't have the authority to pay or approve an amount. Add another remote option to tell the service to skip the user financial authority evaluation for claim coverage payment detail records with a Status of Authority Approved.

    Key

    Value

    AuthorityFailClaimStatus

    Pending Authority

    AuthorityFailClaimCoverageStatus

    Pending Authority

    AuthorityFailClaimCoveragePaymentDetailStatus

    Pending Authority

    ClaimCovPaymentDetailStatusBypassFinancialAuthorityValuation

    Authority Approved

    FinancialAuthorityCheck Remote Action properties in Integration Procedure Designer

  2. Check the CreatePayments Remote Action, which calls InsClaimItemService: createPayments to create payments. Make sure the financial authority check comes before the CreatePayments action. This way InsClaimItemService: createPayments doesn't run unless the financial authority check passes.
    CreatePayments Remote Action properties in Integration Procedure Designer
 
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