Claim Message Group Restriction

The Claim Message Group Restriction features controls who can add, update or remove claim, bill, and claim line messages based on message groups. Each message group can be restricted with an access restriction.

Any message that is in a group that is not restricted can be added, updated (overturn indicator) and removed by any user even if the message is also present in one or more restricted groups. Messages that are not part of any group can be added or removed by any user. Users have access to a restricted group if their role includes the restriction of the group.

How it Works

• Any message that is only in restricted groups can be added to claims, bills, and claim lines only by users who have a role with the Create permission for at least one of the groups that contain the message.

• Any message that is only in restricted groups can be removed only by users who have a role with the Delete permission for at least one of the groups that contain the message.

• There are no restrictions on viewing messages. All users can see all messages of the claims that they are allowed to view.

Example

Table 1. Example

Message Group	Access Restriction	Messages in Group
G1	empty	M1,M2
G2	NONCOVERED	M2,M3

Here, user Bob is granted access restriction NONCOVERED. Pete has no access restrictions. The following table shows which messages they can access.

Table 2. Messages Table

Message	Can Bob add or delete?	Viewable by Bob?	Can Pete add/delete?	Viewable by Pete?
M1	yes	yes	yes	yes
M2	yes	yes	yes	yes
M3	yes	yes	no	yes
M4	yes	yes	yes	yes

Here,

• Bob can add or delete all messages because he has the NONCOVERED restriction.

• Pete can add or delete only unrestricted messages (M1, M2, M4).

• Both can view all messages.

  Inference Prevention

  Not applicable.

  Related Entities

  Not applicable.

Related APIs:

The following APIs check for message group access:

• POST,PUT,PATCH - Generic API claims, claimlines

• Claims In IP

• Claims Update IP