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On-Us claim processing

Updated on June 21, 2022

Pega Smart Dispute for Issuer support On-Us claim processing for Visa, Mastercard, and American Express.

Pega Foundation for Healthcare
  1. When a dispute is eligible for On-Us processing, on the Choose a Reason code view, the Issuer can only choose to process liability actions from local actions in case of American Express, Visa, and Mastercard claim processing.
    Choose a Reason code
    The user can select the reason code and condition code, and also specify answers to ancillary questions.
  2. Upon submitting the Choose a Reason code view, Issuer routes to Process Acquirer response view to proceed with the appropriate action for further processing.
  3. In the Process Acquirer response view, the Issuer can review the dispute amount and select any of the following actions to proceed:
    • Write-off
    • Cardholder liable
    • Acquirer liable
    • Multipronged
  4. If the customer selects Write-off option, the case is resolved as Resolved-WriteOff by sending final credit correspondence to the customer, and respective accounting takes place.
  5. If the customer selects Cardholder liable option, the case is resolved as Resolved-Cardholderliable by sending Cardholder liable correspondence to the customer and respective accounting takes place.
  6. If the customer selects Acquirer liable option, the case is resolved as Resolved-Acquirerliable by sending final credit correspondence to the customer and respective accounting takes place.
  7. If the customer selects Multipronged option, the Issuer can select either Write-off, Cardholder liable, or Acquirer liable checkbox and submit the response. Once the details are submitted, the case is resolved as Resolved-WriteOff , Resolved-Cardholderliable, or Resolved-Splitliable by sending correspondence, and respective accounting takes place.

    The following figure shows an example of the Process Acquirer response view.

    Process Acquirer response
    The user reviews the dispute amount and select appropriate action to resolve the case.

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