Impact of workflow on claim processes
The impact on each process is described in these sections:
Creating claims
When a workflow is active for claims, the Customer/Supplier Claim Document Approval check box is not displayed on the claim header as the claims can be approved at the header level only, using Workflow Document Authorization (WFDA) with ION.
When a workflow is not active for claims, the Customer/Supplier Claim Document Approval check box is displayed on the claim header and is set based on the settings in the Claim Management Parameters (tscmm0100m000) session.
Reviewing claim lines
If the Customer/Supplier Claim Document Approval check box is selected for a claim or if a workflow is active for claims, each claim line must be marked as Reviewed. The option is enabled for the claim line when the claim procedure is executed, and the claim line status is set to Pending Approval.
When you select the option, the Review Customer Claim Line(s) (tscmm1205m000) session (for supplier claims, the Review Supplier Claim Line(s) (tscmm2205m000) session) is displayed. In this session, you can specify the decision reason, the review date and additional text. Infor LN updates this data on the selected claim line(s).
After the review, the claim line status is set to Pending Approval.
When all claim lines status is set to Pending Approval, the option for the claim header is enabled.
Approving claims and claim lines
When a workflow is active for claims, the option is enabled for the claim header only when the status of all claim lines is set to Pending Approval. The claim lines cannot be approved and sent to ION individually.
When you select the option, the claim, with all linked claim lines, is checked-out and sent to ION for WFDA.
The status of the claim header and lines remains Pending Approval but the Workflow Status on the claim header is updated to Pending Approval.
After the approval is received from ION, the status of all claim lines and the claim header is updated to Approved. The Workflow Status on the claim header is also updated to Approved.
When a workflow is not active, these are the two possible scenarios for claims:
| Scenario | Customer/Supplier Claim Document Approval | Impact on claims |
|---|---|---|
| 1 | No | The option on the claim
header is enabled and is used to initiate the approval process for each claim line.
The claim must be approved using the Approve Entire Customer Claim (Line) (tscmm1210m000) session. Note: For supplier claims, the Approve Entire Supplier Claim (Line) (tscmm2210m000) session is used.
The option on the claim header is enabled as long as claim lines with status other than Approved exist. The claim line status is set to Pending Approval only if all pending user actions are processed. Only the claim lines with the Pending Approval can be approved. |
| 2 | Yes | The option on the claim
header is enabled only when the status of all claim lines is set to
Pending Approval. The claim lines cannot be approved
individually. When approving the claim, each claim line status is set to Approved and the claim header status is set to Approved when all lines are approved. The review decision reason is already assigned to each claim line when reviewing the line using the Review Customer Claim Line(s) (tscmm1205m000) session. Note: The Review Supplier Claim Line(s) (tscmm2205m000) session is used to review the supplier claim lines.
|
When a workflow is not active, these are the two possible scenarios for claim lines:
| Scenario | Customer/Supplier Claim Document Approval | Impact on claim lines |
|---|---|---|
| 1 | No | Each claim line can be approved individually. When the claim is submitted, the lines status can be set to Approved and processed further only if no pending user actions exist, and for which the status is set to Pending Approval. The claim line(s) must be approved using the Approve Entire Customer Claim (Line) (tscmm1210m000) session. Note: For supplier claims, the Approve Entire Supplier Claim (Line) (tscmm2210m000) session is used.
|
| 2 | Yes | The claim can only be approved from the claim header only and the claim lines cannot be approved individually. |
Rejecting claims
When a workflow is active for claims, a claim line can be rejected as long as the status is Pending Approval. When a claim, with multiple lines of which one has been rejected, is submitted to ION for approval and the claim document is rejected in ION, the claim lines and header retain the status (Pending Approval and Rejected) and the Workflow Status on the claim header is set to Not Started.
You can modify the claim or the lines data and submit the claim again.
When the claim is required to be rejected based on the rejection in ION, the option on the claim header can be used. The Reject Entire Customer Claim (Line) (tscmm1220m000) is displayed wherein which a rejection reason must be defined.
All claim lines as well as the claim header status is set to Rejected and the claim or claim line data cannot be modified.
When a workflow is not active for claims, an individual claim line can be rejected using the option on claim line. Claim lines status is set to Rejected and line data cannot be modified.
The Reject Entire Customer Claim (Line) (tscmm1220m000) is displayed wherein which a rejection reason must be defined. When this session is accessed for a selected claim line, only the line status is set to Rejected.