Enhancement: Claim Status Request through API for Pended Claims

(Doc ID 2321274.1)

Last updated on OCTOBER 25, 2017

Applies to:

Oracle Health Insurance Claims Adjudication - Version 2.17.2.0.0 and later
Information in this document applies to any platform.

Goal

Enhancement Request: Claim status request through API for pended claims
Currently, if claim status is requested and the claim is in a pended state, the API returns a 409 conflict response. The status of a claim is needed to integrate with a front application. The front needs to know if a claim is in a state where the claim is not processed anymore. A pended claim is in such a state.

The desired result of the request is 220 with information that the claim is pended.

The current workaround is to query the claim itself and determine the claim status, but the desire is for a single approach to determine if a claim is in a 'processing done' status.
 

Solution

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