Updating Your Response/Decision
As an adjuster, you may encounter a situation where you need to update your decision or response on an OCF.
Some examples of possible situations where you would need to withdraw your response and render a new one:
- A facility has contacted the insurer and asked to resubmit an updated version of the form
- The claim-claimant profile was initially set up in the wrong branch and needs to be re-created in a different one
- The decision was rendered in error
In all of these situations, you will need to withdraw the decision on the form and render a new one. Continue reading for more information on how to perform this function in HCAI.
Withdrawing your decision in HCAI:
- Open the plan or invoice you wish to update—you can find previously adjudicated plans or invoices in the ‘Adjuster Response’ tab.
- The plan will open to the ‘Summary’ tab.
- In the ‘Plan Details’ or ‘Invoice Details’ section, press the ‘Withdraw Response’ button. (View screenshot)
- The screen will refresh and the plan or invoice will be placed in ‘Review Required’ status.
- You can now proceed to adjudicate the form. If you need to update the claimant to be in a different branch, you will need to contact a claim-claimant administrator who can unlink the claimant and match it to a claimant in the correct branch.
Please note that adjudication decisions cannot be withdrawn more than 365 days after the decision was rendered.