Resolve Pend on Multiple Claims

This long-running operation allows the user to resolve a specific pend on multiple claims or claim lines by performing the following POST request with the payload:

http://[hostName]:[portNumber]/[api-context-root]/claims/resolvependreasons

{
    "pendReasonCodeList": [
        {
            "code": ""
        },
        {
            "code": ""
        }
    ],
    "level": "claim/claim line",
    "claimList": [
        {
            "id": 123,
            "code": "",
            "claimLineList": [
                {
                    "id": 456,
                    "code": ""
                }
            ]
        }
    ]
}

Details

• It is mandatory to pass at least one Pend Reason Code and Claim id/code.

• When the level is not specified, it is considered as claim.

• Resolve pend reason at claim level:

  • When level is set as claim, the pend reason is resolved at the claim level.

• Resolve pend reason at claim line level:

  • When level is set as claim line, the pend reason is resolved at the claim line level.

    • When level is set as claim line and claim line details are passed in the payload, the system resolves the pend reason only on those specified claim lines.

    • When level is set as claim line and no claim line details are passed in the payload, the pend reason is resolved on all the claim lines (wherever applicable) that belong to the claim.

    • NOTE: Resolving pend reasons at the claim line level is not applicable when the claim code’s process category is Large Claim System.

Process

• The system starts a long-running operation when a POST request is performed on the aforementioned end-point.

  • It is possible to track the progress of long-running operations by interacting with the application through the location header.

    • See Long-Running Operation Through REST for more details.

• The system creates a related entry in the pend reason history for the respective claim and claim line.

Response Handling

• If the Pend Reason Code passed in the payload is unknown or not passed in the payload, then the integration fails, long-running does not initiate, and an error message CLA-IP-RPND-001 is shown.

It is possible that pend cannot be resolved on one or more claim or claimlines. For example, the pend reason is already resolved or does not exist. The claim or claimline itself does not exist.

The IP returns a link in the location header, following which a user can track the status of the long-running operation and the related response messages.

Authorization

A user authorization configuration protects access to this feature. The relevant access restriction is claims.resolvependreason IP.

• In addition, pend reasons can be protected by access restrictions. HTTP API operations will always enforce those access restrictions.

• HTTP status 403 is returned if the current user has no access rights to resolve pend.

Response Messages

Success

HTTP 201 (Created) with links to long-running operation operator and monitor.

Failure

The potential failure responses that a user may encounter are as follows:

Table 1. Failure Responses

Response	Severity	Description
CLA-IP-RPND-001	Fatal	Pend Reason {code} is unknown.
CLA-IP-RPND-002	Fatal	Claim {id/code} is unknown.
CLA-IP-RPND-003	Fatal	Claim Line {id/code} is unknown.
CLA-IP-RPND-004	Fatal	Claim Line {id/code} does not belong to Claim {id/code}.
CLA-IP-RPND-005	Fatal	Level cannot be Claim Line for the Claim {id/code} as the process category is Large Claim.
CLA-IP-RPND-006	Fatal	Access to one or more pend reasons is restricted
CLA-IP-RPND-007	Fatal	Level can only be either claim or claim line
CLA-IP-RPND-008	Fatal	Pend reason code is not specified
CLA-IP-RPND-009	Fatal	Atleast one claim id or code is not specified

See Response Messages for more details.