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.

Use the Transaction Console to:

• Manage Stuck Approvals:
  • 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.

The submitted claim moves 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.

The settlement amount used for approval will not include the amount from Open Deductions, Open Overpayments, and Open Credit Memos.

Ensure that you prefix claim attributes used in approval rules with Claim..