Automated Claim Tasks Article

ClickClaims includes the ability to create and manage claim “Tasks”.  Claim tasks are generated on a claim as a notification or reminder of an action that the assigned user is required to complete within a certain timeframe.  There are two types of claim tasks that may be generated within the application, “Automated Claim Tasks” and “Claim Specific Tasks”.  This article contains detailed information regarding the functionality available when utilizing the automated claim tasks functionality.  

 

Automated Claim Tasks

Automated Claim Tasks are preconfigured tasks that can be automatically generated on any claim within ClickClaims based on predefined trigger points and claim attributes.  This section provides instructions on how to access and manage Automated Claim Tasks.

 

Accessing Automated Claim Tasks:

  1. From the “Tools” menu bar button, mouse over the “Manage” option from the drop-list and select “Automated Claim Tasks” from the fly-out menu.   You're advanced to the “Automated Claim Tasks” data grid page.
  2. Note:  Users must be associated with the “Owner” and/or “Administrator” user role in order to access this feature.

3. From the “Automated Claim Tasks” data grid, select the button to configure a new automated task or highlight a record and click the button to modify an existing task.

4. Note:  The “Automated Claim Tasks” data grid utilizes the same ClickClaims Data Grid functionality available throughout the application.  

 

Configuring New Automated Claim Task:

  1. After selecting the  button from the “Automated Claim Tasks” data grid page, you are advanced to the “Automated Claim Task” page where you may begin configuring the new task.

 

  1. Populate the required and desired fields provided on the “Claim Task Details” tab of the “Automated Claim Task” page.
    1. “Details” Section:

 

  1. Task Name:  Enter the name of this task template.  This is a required field that must contain a value before exiting this page.
  2. Task Detail:  Enter the desired text to support or describe the action required to complete this task.  This is a required field.
  3. Trigger Point:  Select the desired trigger point from the available options within the drop-list.  The option selected determines the point at which this task is generated on eligible claims.  This is a required field.

 


Note: An optional setting is available that, when enabled, provides an additional trigger point of "When Claim Flag is Set".  When chosen as the trigger point, an associated "Claim Flag" field displays allowing you to associate the task to a desired flag.  Additionally, a third, related "When Claim Flag Value Changes From" field displays allowing you to determine what change in the claim flag's setting triggers the task.  This setting is disabled by default.


 Note: An optional setting is available that, when enabled, provides an additional trigger point of "When File Status is Set".  When chosen as the trigger point, an associated "File Status" field displays allowing you to associate the task to a desired file status.  Additionally, a third related "File Status Reason" field displays allowing you to optionally base the file status trigger point on a specific File Status Reason.  This setting is disabled by default.

 

  1. Adjuster Assignment / Reassignment:  If selected, this task generates when the primary Adjuster is assigned or reassigned on the claim.
  2. Adjuster Reopen:  If selected, this task generates when the primary Adjuster is assigned at the point of reopening the claim.
  3. Claim Age:  If selected, this task generates based on the age of the claim.
    1. Note:  When selected as the “Trigger Point”, a new, related “Default # of Days from Trigger Point” field displays requiring the # of days to be set.
      1. Default # of Days from Trigger Point:   This task generates based on the # of days set here, per the “Claim Age” trigger point configuration.  This field is required when “Claim Age” has been configured as the task’s trigger point.

 

4. When Date Is SetThis task generates based on the population of a related claim date.

  1. NoteWhen selected as the “Trigger Point”, a new, related “When Date Is Set” field displays requiring the related claim date field to be set.
    1. When Date Is Set:  Select the related claim date option from the drop-list.  This task generates when the date is set within the associated date field of the claim (changes from a null (blank) value to containing a date/time value).   This is a required field when the “When Date Is Set” option has been configured as the task’s trigger point.

 

 

5. Associated Claim Date:  If the completion of this task is dependent upon the population of an eligible date field within the "Adjuster Actions" section of the claim's "Dates" tab, the task creator can select that date field from the drop-list.  When doing so, the application automatically populates the task’s "Completed Date/Time" and updates its status to "Completed" when the associated claim date is populated on the claim’s "Dates" tab.  This prevents the task's assigned user from duplicating efforts by populating the date/time on the claim's "Dates" tab as well as within the task itself.




  1. Note:  The related date field is located within the claim’s “Dates” tab.

 

6. Assign Task To:  This is a required field to specify who is responsible for completing this task.  By default, only a claim stakeholder can be assigned to an automated claim task.  The available roles are:

  1. Adjuster
  2. Adjuster 2 (if eligible)
  3. Adjuster 3 (if eligible)
  4. Client Examiner
  5. Company Examiner
  6. File Reviewer Team Lead


  • NoteAn optional setting can be enabled that will allow an automated claim task to either be assigned to a specific user based on their user role or assigned to a specific claim stakeholder.  This setting is disabled by default.

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  • When enabled, if “Claim Stakeholder Role” is selected from the “Assign Task To” field, the related “Assign Task to Claim Stakeholder Role” field displays to select the desired stakeholder role responsible for task completion.

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  • If “Individual User by Role” is selected from the “Assign Task To” field, the related “Select a User Role” and “Assign Task to Individual User by Role” fields display.
  • Select the appropriate role from the “Select a User Role” field’s drop-list.  
  • This user role selection then drives the usernames available for selection from the “Assign Task to Individual User by Role” field.

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7. Default # of Days Due:  The task’s “Due Date” is set by adding this # of days to the date the task is generated on the claim.

8. Active:  If unchecked, tasks don't generate for this task template.  

  1. “Auto-Generated Forms & Letters” Section:  

 

  1. If an existing form letter template is selected from this drop-list, the form letter automatically generates and is attached to the task when it’s created.
  1. “Notify Assigned To User” Section:

 

  1. On CreateSelecting this option generates an email notification to the task’s assigned user upon creation.
  2. On Complete:  Selecting this option generates an email notification to the task’s assigned user upon completion.
  3. When Past Due:  Selecting this option generates an email notification to the task’s assigned user when the claim task is passed its due date.
  1. “Notify Monitor” Section:

 

  1. On Create:  Selecting the option generates an email notification to the task’s monitor upon creation.
  2. On Complete:  Selecting this option generates an email notification to the task’s monitor upon completion.
  3. When Past Due:  Selecting this option generates an email notification to the task’s monitor when the claim task is passed its due date.
  4. Monitor:  This is the user who is assigned to overlook the task to ensure it’s addressed in a timely manner.
    1. Company Examiner:  Selecting “Company Examiner” from the drop-list assigns the claim’s associated Company Examiner stakeholder as the task’s Monitor.
    2. File Reviewer Selecting “File Reviewer” from the drop-list will assign the claim’s associated File Reviewer as the task’s Monitor.
    3. Team Lead:  Selecting “Team Lead” from the drop-list assigns the claim’s associated Team Lead stakeholder as the task’s Monitor.
    4. Trigger Person:  Selecting “Trigger Person” from the drop-list assigns the person who caused the task to generate based on the task’s “Trigger Point” as the task's Monitor.  
      1. Example:  If the “Trigger Point” is “Adjuster Assignment / Reassignment”, the person who assigns the claim’s adjuster is the “Trigger Person” and is assigned as the task’s “Monitor”.
  1. “Notify Other User(s)” Section:

  1. On Create Selecting this option generates an email notification to the email address(es) entered within the “Email(s)” textbox of this section upon creation.
  2. On Complete:  Selecting this option generates an email notification to the email address(es) entered within the “Email(s)” textbox of this section upon completion.
  3. When Past Due:  Selecting this option generates an email notification to the email address(es) entered within the “Email(s)” textbox of this section when the claim task is passed its due date.
  4. Email(s):  Enter one or more email addresses here to generate the “On Create”, “On Complete” and/or “When Past Due” email notification(s) for the claim task.  Separate each email address with a semicolon.  
    1. Note:  The recipient(s) do not need access to your ClickClaims site to receive the email notification(s), but they do need a user account to access the task within the application if desired.
    2. Note:  For the recipient(s) to be able to access the claim to which the task is associated, their user account must be associated with a user role that grants them access to the claim.
  1. Once all required and desired fields have been populated, click the button. The “Attributes” tab now displays.
  2. Automated claim tasks can be configured to solely generate on claims containing attributes correlating to the attributes configured within the task template.  To associate attributes to a task, click on the “Attributes” tab of the “Automated Claim Task” page.

 

  1. “Perils” Section:

 

  1. By default, the task is generated on any eligible claim, regardless of the claim’s peril, based on the “All” default setting within this section.  
    1. To configure the task to only generate for eligible claims associated with a specific peril, select the checkbox next to the desired option(s) within the “Perils” section.
  1. “Claim Codes” Section:

 

  1. By default, the task is generated on any eligible claim, regardless of the claim’s claim code, based on the “All” default setting within this section.
    1. To configure the task to only generate for eligible claims associated with a specific claim code, select the checkbox next to the desired option(s) within the “Claims Codes” section.
  1. “Events” Section:

 

  1. By default, the task is generated on any eligible claim, regardless of the claim’s event (CAT Code), based on the “All” default setting within this section.
    1. To configure the task to only generate for eligible claims associated with a specific event, select the checkbox next to the desired option(s) within the “Events” section.
  1. “Clients” Section:

 

  1. By default, the task is generated on any eligible claim, regardless of the claim’s associated client, based on the “All” default setting within this section.
    1. To configure the task to only generate for eligible claims associated with a specific client, select the checkbox next to the desired option(s) within the “Client” section.
  1. “Severity Codes” Section:

 

  1. By default, the task is generated on any eligible claim, regardless of the claim’s severity code, based on the “All” default setting within this section.
    1. To configure the task to only generate for eligible claims associated with a specific severity code, select the checkbox next to the desired option(s) within the “Severity Codes” section.
  1. “Claim File Types” Section:

 

  1. By default, the task is generated on any eligible claim, regardless of the claim’s file type, based on the “All” default setting within this section.
    1. To configure the task to only generate on specific, eligible claim types, select the checkbox next to the desired option(s) within the “Claim File Types” section.
  1. Once all preferred options are selected, as needed, within the “Attributes” tab, click the button to return to the “Claim Task Details” tab of the “Automated Claim Task” page.
    1. Note:  Selecting the  button directs you back to the “Automated Claim Tasks” data grid page.
  2. If finished, click the button to retain all changes made to this task template.
    1. Select the  button to configure a new “Automated Claim Task”.
    2. Select the button to delete the task template you are currently viewing.
      1. A confirmation message displays stating, “If deleted, it cannot be undone.  Are you sure you want to delete this automated claim task?”  Click “Yes” to proceed or “No” to terminate the action.
    3. Select the  button to return to the “Automated Claim Tasks” data grid page.

 

 

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