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--- claim_contract_resolution [2022/02/14 11:21] – created lisa.maloney
+++ claim_contract_resolution [2025/01/14 17:45] (current) – tina.robles
@@ Line 6: / Line 6: @@
   - XREF_CONTRACT_PAID_CLAIM/XREF_USER_CONTRACT_SEQUENCE
   - CLAIMANT_CONTRACTEE_MATCH
+  - PAID_CLAIM (Deprecated)
   - CLAIMANT_CONTRACTEE_MATCH_RELAXED
   - SAME_CONTRACT_NAME_AS_RESOLVED_LINE
+NOTE:  Any contracts with a type of AUTOPAY will not be part of the auto matching process for claims to contract.
 -----
@@ Line 16: / Line 19: @@
 For example, if there is a mapped column in the eclaim file to Contract Sequence and the value in the file is 1001000, that eclaim row will be mapped to contract family ID 1001000 in the application.
+-----
+**XREF_CONTRACT_PAID_CLAIM/XREF_USER_CONTRACT_SEQUENCE**
+If a match for the exact claimant company, contract hint, and product exist in the new paid claim contracts and alias lookup table, we will resolve to that contract.
+For a key to make it to the table, there must be at least one line paid for this product/claimant/hint against the contract in the last X days (system configurable), and no lines paid against another contract for the same product/claimant/contract hint in the same period.
+Internal users may add records to this table for any product/claimant/hint that either create a new mapping or exclude a given contract for ever auto matching for that product/claimant/contract hint.  New lines paid are added to this lookup table nightly, and system-created mappings for contracts that have not been paid again within the timeframe are deactivated.
+-----
+//All the resolutions detailed below first require the resolution of a single contractee company (or group) based on mapped claimant contractee xrefs.//
+-----
+**CLAIMANT_CONTRACTEE_MATCH**
+If there is one and only one contract found for the line item’s product and time period where the contractee is the resolved company or group from the Claimant Contractee Xref, then we resolve to that contract.
+-----
+**PAID_CLAIM (Deprecated)**
+The system will look for a paid claim driven by the claimant contractee mapping and claimant contract name. If there are multiple contracts only found for the contractee, then a contract would not be matched.
+-----
+**CLAIMANT_CONTRACTEE_MATCH_RELAXED**
+If we did not find a match previously, relax the requirement that the product be eligible on the contract and that the timeframe matches.  If there’s only one valid contract for the resolved contractee (either company or group), match to it.
+-----
+**SAME_CONTRACT_NAME_AS_RESOLVED_LINE**
+If one or more lines on an invoice resolved to a single contract, match all other lines with that same Claimant Contract Name to that contract.  (Exception is if a specific Exclusion exists for this product/claimant/hint for the resolved contract we will NOT resolve those specific SKUs).
+-----
+Lines that Did Not Resolve get coded one of two ways.
+. MULTIPLE_MATCHING_CONTRACTS
+There was no paid claim xref or user-created alias, and the Contractee Match steps found multiple matching contracts, and thus we could not resolve this line to a single contract.  (These will be significantly reduced over time by the paid xrefs and user-created aliases resolving before we get to the “old” process).
+. NO_MATCHING_CONTRACTS
+No matching contracts were found in any of our steps for the given line item.  Check the contractee mapping to ensure that is the correct contractee.
+-----
+On the claim header, hover over the Contract Title to view how the contract was resolved.
+{{:pasted:20220214-113257.png}}

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