Access Restriction for Claims Jet Pages

Access to all UI pages is protected by access restrictions of type Function. Each page is represented by an access restriction of type function. So a user can only access pages he has been granted access to via one of his roles. Function access is granted on the level of a page. It is not possible to give access to certain parts of a page. For example, when the user has access to the persons page, he can search for persons, he can access all parts of that a view and edit person page like person data, person addresses, person bank accounts and so on.

A user can be granted Retrieve access to a page, and optionally also Create, Update, and/or Delete access. Create access means that new records (objects and its details) can be added. Delete access means that records can be deleted. Dynamic fields and multi-select drop down lists are considered attributes of an entity, if the user has Update access to the page he can add/remove/update such attributes even if he does not have Create or Delete access.

Menu options to which the user does not have access, are not shown. On a page to which the user has access, add / delete / save buttons are hidden if the user does not have access rights for that operation. If the user does not have update access, fields are displayed as read-only.

The pages uses HTTP API/resources and Integration points (generic/specific) to perform special operations, e.g submitting a claim or resolving a pend. Access to these operation must be granted explicitly.

Whenever a page access is provided to a user, access to required IP/API is automatically granted. However, exception to the rules are IP/API that allow user to perform certain restricted operations e.g. submitting a claim or put a claim back to change

The following table provides details on pages that require additional API/IP access to perform special operations - function code - API/IP access required

Claims

Page Function Access Restricted Access Restrictions

Claims

CL0172

  • To be able to work on a claim (edits) in the status Change, Manual Pricing, Manual Pricing Adjudication, Manual Benefits, and Manual Adjudication the user must have access to operation’Submit Claim' in its respective status or for 'all' statuses and function access update grant to 'CL0172' In addition to above, to be able to perform special operations, additional grants might be needed.

  • To unfinalize a claim the user must have access to operation Unfinalize Claim and access grant of type Claim Unfinalization

  • To set claims back to status 'Changed' the user must have access to operation Back to Change

  • To set claims back to status 'Manual Pricing' the user must have access to operation Back to Manual Pricing

  • To set claims back to status 'Manual Benefits' the user must have access to operation Back to Manual Benefits

  • To set resolve pends the user must have access to operation Resolve Pends.

  • To undo claim line replacements, the user must have access to operation Undo Line Replacement

  • To view/edit financial holds user must have access to generic api Financial Hold

  • To settle/unsettle a claim user must have access to access grant of type 'Claim Settlement' and update grant on external claims data generic API.

  • To unlock claim lines, the user must have access to Operation Unlock Lines

  • To change skip tags action, the user must have access to Operation Update Skip Tags

  • To view/edit external claims data the user must have appropriate access grant to generic api externalClaimData

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