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Managing claim queries

Claims may be queried during the approval workflow by a user in a workflow group, for example to dispute the value or agreement breakdown.

Claim queries can be easily monitored and actioned in Enable, providing a smoother approval process.

This article will guide you through:

  1. How to access queried claims
  2. How to resolve a query on a claim

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How to access queried claims

To review queried claims:

Step 1: Within the Claims app, click on Dashboard in the green banner at the top of the page.

Step 2: Review the following tiles:

  • Number of queried claims: Indicates how many claims require resolution.
  • Total value of queried claims: Indicates the monetary impact of these queried claims.
Claims Dashboard

Step 3: Click on one of these tiles to display the claims listing filtered by queried claims.

Step 4: To view details of a query, click on the individual name of the claim to display the manage claim page.

Claims listing filtered by queried claims

How to resolve a query on a claim

When a claim has been queried, a banner is displayed at the top of the claim. This indicates the workflow group who queried the claim, and which workflow group the query is with to resolve.

Queries can be resolved by a user within the first workflow group (i.e. the group who drafted the claim), or a claims admin user. Users with the relevant permission will see the Resolve query button.

Viewing a queried claim

To resolve a queried claim:

Step 1: Click the Resolve query button in the claim to view comments from the user who queried the claim.

Resolve query on a claim

Step 2: Click on one of the following options:

  • Adjust Claim: Use this option to adjust the claim value using an agreement level breakdown, for example if there is a valid query about the total amount to be paid. Add a comment, for example to explain the reason for the adjustment. Then click the Adjust Claim button to save the adjustment values. Note that any adjustment made to the claim will not make any changes to the claims calculation for future claims.
  • Continue workflow: Use this option to add a comment, for example to explain the reason why the claim is correct. Then click the Continue workflow button to continue the claim’s workflow from its current state.
  • Stop workflow: Use this option to add a comment, for example if transactions shouldn’t have been included in the claim. Then click the Stop workflow button to regenerate the claim and make changes to it, before starting the workflow from the beginning.

What’s next?

Ready to learn more about managing claims? Learn how to prioritize actions via the claims dashboard here.

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