Claim Approvals

In this topic, you'll learn about how claim approvals work with BPM Workflow.

If you've opted into the Approve Customer Claims with BPM Workflow feature, then configure claim approval rules through Business Process Management workflow to process and route to designated approvers. If you've not opted into the feature, then the application uses privilege based approvals.

You can:

• Manage Stuck Approvals using the Transaction Console:
  • View in-flight and completed approval processes using the keyword Customer Claim.
  • Terminate the approval process and move the claim to Open status.
  • Restart the approval process after correcting the approval rule.
• Skip approvals
  • If you settle a claim using only Open Deductions, Open Overpayments, or Open Credit Memos, then the application skips the approval process and moves the claim directly from Open to Settlement Pending status. This applies only if the Approve Customer Claims with BPM Workflow feature is opted in.
• Submitted claim reverts to Open status
  • The submitted claim will move from Approval Pending to Open status if the approval task flow is in error. This can happen if there are no active stages or participants.
• Settlement amount used for approval
  • The settlement amount used for approval will not include the amount from Open Deductions, Open Overpayments, and Open Credit Memos.
• Claim attributes in approval rules
  • Claim attributes used in approval rules must be prefixed by Claim..