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Reprocessing the Claims after Response from ClaimsXten

Updated on October 9, 2020

The system only reprocesses the entire claim automatically if a new line is added via ClaimsXten. The claim goes through the entire adjudication process again.

If the response has an added line:

  1. The system modifies the claim work object to add the new line based on the response received.
  2. The claim is reprocessed to adjudicate the newly added line. Existing lines are also readjudicated.
  3. SCE would bypass the ClaimsXten module when the claim is reprocessed as it has already received the response from CXT.

Process history tab on the claim will have execution sequence recorded for the reprocessed claim.

ClaimsXten module will be bypassed as it has already received a response from CXT. The reason for the bypass is captured in the audit trail.

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