XactAnalysis (XA) Importer Article

Administrator E-Claim

Modified on: Mon, 21 Oct, 2024 at 4:11 PM

ClickClaims offers the XactAnalysis Importer (XAI) service as an optional feature to automate the creation of claim files in the ClickClaims application from XactAnalysis (XA). The list of available messages (data) that can be sent from XactAnalysis to a third party, like ClickClaims, is extensive so a full list should be secured from Xactware, if needed. ClickClaims base XactAnalysis Importer service includes a subset of available messages which are described in this article, along with details regarding its functionality. Changes to the base XactAnalysis Importer (XAI) service and any special handling requires a submission of a Change Request via a support ticket submitted by an authorized person at your company.

Additionally, the optional XactAnalysis Exporter (XAE) service is available as a custom solution. This service allows claims created in the ClickClaims application to be sent to XactAnalysis (XA), as well as the ability to send individual CMS file documents to an existing XA claim record.

Default XactAnalysis Importer Configuration

Claim Creation: The claim will be imported and created in ClickClaims with the FNOL information received from XactAnalysis.
“Adjuster Received” Date: The “Adjuster Received” date will be automatically set on the claim in ClickClaims CMS when the “Delivered” message is received from XactAnalysis.
“Initial Contact” Date: The “Initial Contact” date field will be automatically populated on the claim in ClickClaims CMS when the “Contacted” message is received from XactAnalysis.
“Loss Inspected” Date: The claim’s “Loss Inspected” date field will be automatically populated on the claim in ClickClaims CMS when the “Inspected” message is received from XactAnalysis.
“Adjuster Assigned” Date: The adjuster will be assigned to the claim in ClickClaims CMS, and the “Adjuster Assigned” date automatically populated, when the “Notified” message is received from XactAnalysis.
“Pending Manager Review” File Status: The claim’s file status will be updated to “Pending Manager Review” in ClickClaims CMS when the claim is marked as “QA Approved” in XactAnalysis and they send the “Returned” message.

Optional XactAnalysis Importer Messages

The XactAnalysis Importer service can be configured with the optional functionality listed below per request. Please note that you should work with your Xactimate representative to ensure XactAnalysis is also configured to export the desired information as ClickClaims can only import claim data that has been exported from the XactAnalysis system.

Adjuster Assignment: If the claim already exists in CMS as “Open – Not Assigned”, when the claim is assigned to the adjuster in XactAnalysis, the claim can in turn be assigned to the adjuster in CMS automatically updating the file status to “Assigned to Adjuster”.
1. If this option is not enabled, the existing claim must be manually assigned to the adjuster in both applications independently.
Duplicate Claims: By default, ClickClaims CMS will reject duplicate claims. Optionally, though, the XA Importer can be configured to allow duplicates.
1. CMS identifies duplicates by reviewing the following information on all new claims sent from XactAnalysis:

XactAnalysis Transaction ID (XA ID #): This is the unique number XactAnalysis assigns to each XactAnalysis claim. If the “XA ID” of the claim sent from XactAnalysis matches an existing CMS claim record, the claim will be identified as a duplicate and, by default, will not be imported.
1. The “XA ID #” is located in CMS within the “CMS #” field of the claim’s “Summary” tab.

Claim Number and Associated Client: If the claim to be imported into CMS from XactAnalysis contains the same claim number (“Client #”) and is associated to the same carrier/client record as a claim already residing within the CMS application, it will be identified as a duplicate and, by default, will not be imported into CMS.

Note: If an existing claim contains the same “Client #”, but is associated with a different “Client” record, or if an existing claim is associated to the same “Client” record, but contains a different “Client #”, the claim will be imported into the ClickClaims CMS application.

“Companion” Flag: If there is an existing claim with the same “Client” (carrier) associated and with the same “Policy #”, a companion claim is made in CMS. If matches exist, the new claim being imported will have the “Companion” claim flag in CMS set to “Yes” automatically when this option is enabled.
Commercial Flag: When enabled, if the claim received from XactAnalysis is identified as a commercial claim (per the XML file received from XactAnalysis), the “Commercial” flag will be set to “Yes” when the claim is created in CMS.
Documents: Documents existing within the claim in XactAnalysis can be imported into the claim in CMS when this optional feature is enabled. These documents can include FNOL and/or policy documents that are transmitted with the XA “Assignment” message and added to the newly created CMS claim. Adjuster work product documents can also be automatically imported into the claim’s “Documents” tab in CMS.
File Status: Rules can be created to change the claim’s CMS “File Status” upon receipt of certain XactAnalysis messages. For example, if the adjuster is reassigned on the claim in XactAnalysis, the XactAnalysis Importer can be optionally configured to also reassign the adjuster on the claim in ClickClaims.
1. Reassign: If the “Reassignment” status option is configured, and a CMS adjuster match is found, the adjuster will be updated on the claim and an activity note will be added to the claim’s “Notes” tab stating that it was reassigned to the new adjuster.

Note: If a CMS adjuster match was not found, the claim will be placed in the “Open – Not Assigned” status and added to the “Activity – Pending Adjuster Assignment” CMS widget as a “Mismatch” and an activity note will be added to the claim’s “Notes” tab stating that the claim was reassigned, but the matching CMS adjuster could not be found.

By default, when the assigned claim is imported from XA to CMS, the file status will be set as “Assigned to Adjuster”.
By default, when the unassigned claim is imported from XA to CMS, the file status will be set as “Open – Not Assigned” and the claim will be placed in the “Activity – Pending Adjuster Assignment” widget in CMS.
By default, when the claim is marked as “QA Approved” in XA, the claim’s CMS “File Status” will be updated to “Pending Manager Review”.

Invoice Gross Loss (GL): XA messages can be customized to include Gross Loss (GL) amount, which would then be displayed in the CMS Billing/Indemnity screen, as shown here:

While XA may require customization on their end to include the GL amount in certain messages, the ClickClaims importer has been designed to work with or without the GL field and does not require customizations. If multiple messages are received, causing the related field values to change over time, the history of all messages is recorded and can be viewed by clicking on the red X shown in the above image.

Assignment Notes: E-Claim offers the ability to import XactAnalysis assignment notes into the ClickClaims CMS claim via the XactAnalysis Importer EDI (Electronic Data Interchange).
1. The XactAnalysis assignment note will be added to the ClickClaims CMS claim’s “Notes” tab, located within the “Company User” note type and “Activity Note” sub-type.
  1. If you, the client, desire the activity note to be logged under a different Note Type and/or Sub-Type instead, simply notify E-Claim of your requirement specifications during your request to have this feature activated, and E-Claim will change the location to meet your preference. Otherwise, the default settings will be configured upon the initial setup.
2. The CMS activity note’s text details are as follows:
  1. The text will contain the XactAnalysis original assignment note body text. However, CMS will display it in plain text only (no html or rich text formatting).
  2. The text will also include the wording, “Imported from Xactware”, followed by the date and time stamp of the actual occurrence of the note’s import to CMS from XactAnalysis.
  3. The username of the creator of the note, displayed within the “Source” column in the assignment’s XactAnalysis “Notes” tab, will be contained within the CMS activity note.

Claim Import:

XA will deposit the assignment file (XML) on an FTP site which is swept by ClickClaims every three minutes (24/7/365). The XML file is read by the CMS importer, and the fields required for file setup in CMS are mapped appropriately, creating the new claim record in CMS.
The entirety of the assignment file is automatically saved as a .TXT file within the “System Documents” file type on the claim’s “Documents” tab so that full details of the assignment are available as a reference.

As shown below, the mapped fields are labeled and displayed at the top of the .TXT file, with the full XML detail as received by XactAnalysis:

Adjuster Assignment:

Files received with the adjuster already assigned will be assigned to that adjuster in CMS. This is done via the “XactNet Address” field located within the user profile record:

The value entered in the “XactNet Address” field in CMS must be an exact match with the adjuster’s XactNet Address in XactAnalysis in advance or the imported claim will be flagged on the CMS dashboard as an 'XA Mismatch'.
1. Claims imported into CMS from XactAnalysis that have an assigned adjuster with an XactNet Address that cannot be located within an adjuster’s user record in CMS will be located within the “Status – Pending Adjuster Assignment” widget by selecting “XA Mismatches” from the “List ALL” field’s drop-list.

Once you have entered/corrected the “XactNet Address” field within the correct adjuster’s user record in CMS, select “XA Mismatches” from the “Status – Pending Adjuster Assignment” widget on the Dashboard and then click the button.

If an adjuster record is located in CMS that contains an exact “XactNet Address” matching the assignment XML file received from XactAnalysis, the claim will be properly assigned in CMS.

If the dashboard still shows mismatches, you will need to follow this process above again, confirming the address in CMS with the address in XactAnalysis, until all such claims have been correctly matched and assigned.

Carrier Assignment:

The importer will process claims to the correct carrier (CMS Client), using the 'XactAnalysis Carrier ID', in each client's profile, as shown below. As with adjusters, the carrier profile must be updated with the XA ID prior to import, in order to create each claim under the correct client. Claims that do not match to any client will be created, but no client will be assigned.

Any CMS client can be added to the importer process and does not require any action by E-Claim. To import claims to other clients, simply add each client's “XactAnalysis Carrier ID” (obtained by Xactware) within the field of the same name of their client profile record in CMS, and the importer will begin creating claims under that client.
1. Note: To be clear, once the XA Importer service is active, you can decide for which of your clients the XA Importer should be used. No additional E-Claim charges apply when clients are added.

XA Messages and CMS Updates:

A “XactAnalysis Status” section (also referred to as the “X Box”) will display at the bottom of the claim’s “Dates” tab for any claim that is created via this process. The image below shows the fields that are updated in CMS as the related messages are received from XactAnalysis.

Note: Only accessible by users associated to the “Owner” or “Administrator” user roles.
These messages are processed every three minutes, allowing a nearly real-time view of the XA status of that claim, starting with the Receive Date.
The display includes the field values from XA, as well as the name of the Xactware user’s name and ID, and the date/time stamp for each message triggering event (note that all XA times are recorded/displayed in mountain time).
1. The CMS activity note entries and date field values received via the XA Importer will be converted to eastern time, so that all dates and activity notes entries will be consistent, whether entered directly into CMS or via the XA Importer process.

Because the above events can occur multiple times during the lifecycle of the claim, the current value displays in the “XactAnalysis Status” section’s grid (the X Box), but the full history and chronology of all changes is tracked within “Xactware Information History” window which can be viewed by clicking the button located within the “XactAnalysis Status” section on the claim’s “Dates” tab.

The following ClickClaims CMS fields are updated upon receipt of XA messages that contain these field values, in addition to the fields shown in the X Box:
1. File Created (date/time importer creates the CMS file)
2. Adjuster Assigned (date/time adjuster assignment occurs in XA)
3. Insured Contacted (date/time adjuster contacts insured)
4. Scheduled Appointment (Based on the “Planned Inspection Date” XactAnalysis field. XA EDI must be configured by Xactware to support this.)
5. Loss Inspected (date/time adjuster inspects loss)
6. Pending Manager Review (requires custom rule to change status on Estimate Received message)

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