After Pega Smart Claims Engine for Healthcare processes a reporting claim, it edits the claim just as it does for a chargeable claim, except that it sets these values:

• Paid Amount = 0

  The reporting claim goes through the adjudication process, calculates values for the Allowed amount, Copay, and Coinsurance, similar to a chargeable claim. However, it sets the Paid Amount to 0.

• Paid Date = Claim Process Date
• Final status of the Reporting claim = Resolved - Completed, assuming that the Reporting claim did not meet any event code criteria.

• Reporting claims