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Name

ProcessingClaims

Type

View

Description

Resolved claim data including system and user action counts for evaluating actiona automation, straight-through processing, and processing time.

Fields

Data Category

Event Field/Column Name

Data Type

Description

Applicability

Sample Value

Notes

Key

TenantId

VARCHAR

Unique ID associated with each Quavo client.

ALWAYS

qvo-stg

Key

Tenant

VARCHAR

A tenant is a Quavo customer that uses QFD.  Each tenant is assigned a unique Tenant ID.

ALWAYS

Default

Key

ClientId

VARCHAR

A unique ID representing a single client.

ALWAYS

Default

Key

Client

VARCHAR

A client is a Quavo customer that uses QFD through a relationship with a Quavo tenant.  Each client is assigned a unique Client ID.

ALWAYS

Default

Claim Details

ClaimType

VARCHAR

See Transaction Type.

CONDITIONAL

Card-Pinless

Claim Details

ClaimCategory

VARCHAR

General categorization of the claim.

For a more precise description, see Claim Reason.

CONDITIONAL

Fraud

Claim Details

ClaimReason

VARCHAR

Identifies the specific reason associated with the claim.

CONDITIONAL

Stolen

Compliance Details

RegulatoryCoverage

VARCHAR

Identifies the specific reason associated with the claim.

CONDITIONAL

Reg E

Claim Details

ClaimChannel

VARCHAR

The Claim Channel defines the intake channel where the claim originated. This channel can include various avenues such as online banking, back office users, contact centers, or external 3rd party contact centers. 

ALWAYS

Online Banking

Key

ClaimId

VARCHAR

Unique ID associated with a claim.  Format: YYMMDD<Ordinal Number>"C"

Example: 2405230003C

ALWAYS

2306060014C

Claim Details

CreateDate

DATE

The datetime that a record was created.

CONDITIONAL

2023-09-09

Claim Details

ClaimAmount

NUMBER(

The sum dispute amount of all posted disputes on a claim.

CONDITIONAL

123.45

Claim Details

ClaimStatus

VARCHAR

Represents the current stage or step of a particular process or lifecycle, such as a claim or dispute.

ALWAYS

RESOLVED-PAID

Claim Details

ResolvedDate

TIMESTAMP_NTZ(9)

Datetime that a claim or dispute is set to a "Resolved" status..  Also referred to as RESOLVEDDATETIME.

CONDITIONAL

2023-09-09 21:00:00

Processing Details

SystemActions

NUMBER

Count of actions taken by the system on a claim.

ALWAYS

8

Processing Details

UserActions

NUMBER

Count of actions taken by a user on a claim.

ALWAYS

2

Processing Details

TotalActions

NUMBER

Count of all actions taken on a claim.

ALWAYS

10

Processing Details

ProcessingTime

NUMBER

Difference between Create Date and Resolved Date, in days.

ALWAYS

14

SQL

SELECT
    c.tenantid,
    t.name,
    c.clientid,
    cl.legalname,
    c.claimtype,
    c.reasontype,
    c.reason,
    (CASE
        WHEN c.rege45datetime IS NOT NULL THEN 'Reg E'
        WHEN c.rege90datetime IS NOT NULL THEN 'Reg E'
        WHEN c.regz90datetime IS NOT NULL THEN 'Reg Z'
        WHEN c.isfcra = TRUE THEN 'FCRA'
        ELSE 'No Coverage'
    END) AS RegulatoryCoverage,
    c.channelorigin,
    c.claimid,
    c.claimamount,
    c.status,
    (SELECT COUNT(*) FROM completedactions AS a WHERE a.tenantid = c.tenantid AND a.claimid = c.claimid AND a.addedbyid = 'System' AND a.flowtype NOT IN ('RequestReopenScreenFlow', 'RequestCaseWithdrawn', 'LaunchLetterHub', 'IntakeScreenFlow') AND a.flowaction != 'ResendPreviousCorrespondence') AS SystemActions,
    (SELECT COUNT(*) FROM completedactions AS a WHERE a.tenantid = c.tenantid AND a.claimid = c.claimid AND a.addedbyid != 'System' AND a.flowtype NOT IN ('RequestReopenScreenFlow', 'RequestCaseWithdrawn', 'LaunchLetterHub', 'IntakeScreenFlow') AND a.flowaction != 'ResendPreviousCorrespondence') AS UserActions,
    SystemActions + UserActions AS TotalActions,
    (CASE
        WHEN SystemActions = TotalActions then 'Processed Straight Through'
        ELSE 'Manual Processing Required'
    END) AS Processing,
    TO_TIMESTAMP_TZ(c.createdatetime::varchar || ' +0000'),
    TO_TIMESTAMP_TZ(c.resolveddatetime::varchar || ' +0000'),
    DATEDIFF(d, c.createdatetime, c.resolveddatetime) AS ProcessingTime
FROM claim AS c
JOIN tenant AS t ON c.tenantid = t.tenantid
JOIN client AS cl ON c.tenantid = cl.tenantid AND c.clientid = cl.clientid
WHERE
    c.status IN ('Resolved-Paid', 'Resolved-Denied')
ORDER BY
    c.resolveddatetime DESC

Change Log

Date

Change Summary

12/19/2024

New

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