Claims Pending at Manual Pricing Adjudication Step with Pend Reason HP_PRC_ALLOWED_AMT_QA

(Doc ID 2260501.1)

Last updated on APRIL 28, 2017

Applies to:

Oracle Health Insurance Claims Adjudication - Version 2.16.1.0.0 and later
Information in this document applies to any platform.

Symptoms

Claims are getting pended at Manual pricing Adjudication step with pend reason HP_PRC_ALLOWED_AMT_QA(Pend for blank allowed amount) on claim line where the claim line got denied with a message rule applied before the reimbursement method applied.

Claimline which has pended should have 0 allowed amount and claim should process further.

The issue can be reproduced at will with the following steps:
Send in claim with blank allowed amount.


Changes

 

Cause

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