Add Pend
This synchronous integration point allows the user to add a specific pend reason on multiple claims and claim lines by performing the following POST
request with the payload:
http://[hostName]:[portNumber]/[api-context-root]/claims/addpendreason
{
"pendReasonCode": "PEND_001",
"level": "claim",
"claimList": [
{
"id": 123,
"claimLineList": [
{
"id": 456
},
{
"code": "CLAIM_LINE_001 "
}
]
},
{
"code": "CLAIM_001",
"claimLineList": [
{
"id": 345
},
{
"code": "CLAIM_LINE_002"
}
]
}
]
}
Details
-
It is mandatory to pass the
Pend Reason Code
andClaim id
/code
.. -
It is possible to add
Pend Reasons
to claims only when a claim is in the following statuses:-
In Process
-
Change
-
Manual Pricing
-
Manual Benefits
-
Manual Pricing Adjudication
-
Manual Adjudication
-
-
When the
level
is not specified, it is considered as claim. -
Add pend reason at claim level:
-
When
level
is set asclaim
, the pend reason is added at the claim level.
-
-
Add pend reason at claim line level:
-
When
level
is set asclaim line
, the pend reason is added at the claim line level.-
When claim line details are passed in the payload, the system adds the pend reason only to those specified claim lines.
-
If no claim line details are passed on to the payload, then the pend reason is added to all the claim lines that belong to the claim.
-
NOTE: Adding pend reason at the claim line level is not applicable when the claim code’s process category is Large Claim System.
-
-
-
After successful processing, the system creates a related entry in the pend reason history.
Authorization
A user authorization configuration protects access to this feature.
The relevant access restriction is claims.addpend IP
.
HTTP status 403 is returned if the current user has no access rights to resolve pend
Response Messages
Failure
The potential failure responses that a user may encounter are as follows:
Code | Severity | Message |
---|---|---|
CLA-IP-APND-001 |
Fatal |
Claim {id/code} is unknown. |
CLA-IP-APND-002 |
Fatal |
Claim Line {id/code} is unknown |
CLA-IP-APND-003 |
Fatal |
Pend Reason {Code} is unknown |
CLA-IP-APND-004 |
Fatal |
It is not possible to add a pend reason on claim {id/code} with status {claim status} |
CLA-IP-APND-005 |
Fatal |
Atleast one claim id or code is not specified |
CLA-IP-APND-006 |
Fatal |
Claim line {id/code} does not belong to Claim {id/code} |
CLA-IP-APND-007 |
Fatal |
Level cannot be |
CLA-IP-APND-008 |
Fatal |
Level can only be either claim or claim line |
CLA-IP-APND-009 |
Fatal |
Pend reason code is not specified |
The response can also contain generic error messages not specific to this web service. See Response Messages for more details.