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ApiGenerated

ClaimStatus

ClaimStatus type definition

ClaimStatus

ClaimStatus type definition

Properties

  • id (string): Unique identifier for the status record.
  • claim ([[InsuranceClaim]]): The claim this status applies to.
  • status (string): Current status (submitted, under-review, investigating, pending-info, approved, denied, closed, appealed, settled).
  • substatus (string): Detailed substatus for additional context.
  • phase (string): Processing phase (intake, investigation, evaluation, decision, payment, closure).
  • stage (number): Numeric stage indicator.
  • description (string): Human-readable description of current status.
  • reason (string): Reason for current status.
  • changedBy ([[User]]): User who changed the status.
  • changedDate (number): Date when status was changed (Unix timestamp).
  • previousStatus (string): Previous status before this change.
  • nextSteps (string[]): Expected next steps in the process.
  • pendingActions (string[]): Actions required to advance status.
  • blockers (string[]): Issues blocking progress.
  • assignedTo ([[User]]): User currently responsible for claim.
  • dueDate (number): Expected completion date for current stage (Unix timestamp).
  • slaStatus (string): Service level agreement status (on-time, at-risk, overdue).
  • daysInStatus (number): Number of days in current status.
  • totalDaysOpen (number): Total days since claim was filed.
  • notifications (object[]): Notifications sent about this status.
  • history (object[]): Complete status change history.
  • metadata (object): Set of key-value pairs for storing additional information.

Actions

update

Update the claim status.

Input: [[StatusUpdate]]
Output: [[ClaimStatus]]

advance

Advance to next stage.

Input: [[StatusAdvance]]
Output: [[ClaimStatus]]

regress

Move to previous stage.

Input: [[StatusRegress]]
Output: [[ClaimStatus]]

hold

Put claim on hold.

Input: [[HoldRequest]]
Output: [[ClaimStatus]]

release

Release claim from hold.

Input: [[ReleaseRequest]]
Output: [[ClaimStatus]]

escalate

Escalate claim status.

Input: [[EscalationRequest]]
Output: [[ClaimStatus]]

notify

Send status notification.

Input: [[NotificationRequest]]
Output: [[Notification]]

addNote

Add status note.

Input: [[Note]]
Output: [[ClaimStatus]]

viewHistory

View status change history.

Input: [[ClaimStatus]]
Output: [[StatusHistory]]

Events

  • updated: Triggered when status is updated.
  • advanced: Triggered when status advances.
  • regressed: Triggered when status moves backward.
  • held: Triggered when claim is put on hold.
  • released: Triggered when claim is released from hold.
  • escalated: Triggered when claim is escalated.
  • SLA.breached: Triggered when SLA is violated.
  • Notification.sent: Triggered when status notification is sent.