Telus TPM Documentation
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Claim Edit
To access Claim Edit features, a user must be set up with the Claim Edit Access Role. Certain edit features are available when the claim is in View mode, but first let’s look at a claim in Edit.
To access the claim in Edit, click the Edit button in the Actions menu.
Claim Header
In the Claim Header, the Claim Tag field is editable. This field captures the name of the contract as it appears on the invoice and is used as a reference to selecting a contract.
Products
Products can be added, deleted or modified. To add a manufacturer product, search for the product on either the Contract Products (displays products on the specific contract) or Products grid (displays all products) by entering the product number or product name in the grid filters.
Select one to many rows to add to the claim by clicking and highlighting the rows. Multiple lines can be selected by using the ctrl+click or shift+click option. Once the rows are highlighted, drag them to the left and they will display on the claim products grid.
To add products which do not exist in the manufacturer products tab, click the Add Adhoc Product button.
The Product Number, Product Name and Rebate UOM must be entered on the Adhoc product row.
For all products, enter in the Rebate UOM, Date, Requested Quantity, Requested Rate and Requested Total.
Rebate UOM - this will default to the UOM for that product on the contract, or the Default UOM if the product is not on the contract. The dropdown will display the UOM options defined for that product.
Date – the default date displayed is the mid-date between the Start Date and End Date of the claim. This date can be updated to the actual product delivery date, but it must be between the start and end dates of the invoice.
Requested Quantity – enter in the quantity for the product.
Requested Rate – enter in the rate for the product and the Requested Total will auto-populate with the total value. The calculation is quantity x rate.
Requested Total – enter in the total for the product and the rate will auto-populate. The calculation is total ÷ quantity.
NOTE: Quantity and Total can be negative, but Rate must always be positive. It is not necessary to enter both a rate and a total – entering the quantity and either rate or total will calculate and populate the grid for the remaining field. Any calculated (non-entered) values which are rounded in the application will display an approximate symbol (~) and the actual value will display on hover.
There is also the option to delete products from the grid. Select the checkbox at the beginning of a row by either selecting the individual row or clicking the Select All button. To de-select all rows, click the Select None button. Once the row(s) are selected then click Delete Selected.
After clicking Delete Selected, a confirmation popup will display. To continue with the product delete select Confirm and the popup will close and the selected product(s) will be deleted. Click Cancel to cancel the product delete process.
LumpSums
LumpSums can be deleted, added or modified when in Edit mode. To add lumpsums to the claim, select either the Add Contract Lumpsum or Add Lumpsum buttons. Note that the Add Contract Lumpsum button will only be enabled if there are lumpsums available on the contract assigned to the claim.
Select a lumpsum row by checking the box on the lumpsum row. To select all lumpsums to add to the claim, click the Select All button. Multiple lumpsums can be added to the claims. After the rows are selected, click the OK button to close the popup and add the lumpsums to the claim.
The Date and Claim Amount Requested fields are editable for all lumpsum rows. The Date field defaults to the mid-date of the claim start and end dates but can be modified to a specific date. That date must be between the claim start and end dates. The Claim Amount Requested can also be entered or modified.
Resolving Pending Lines
To resolve pending lines while in Edit mode, click the Reason Codes hyperlink for the pending lines on product or lumpsum rows. This will display a Claim Product Reason Codes popup with the Pend reason displayed and Override, Recalc, and Reject options. The options displayed depend on the pend reason, so if the line is pending for Ineligible Sku, the Recalc option will not be enabled.
To override this line, click the Override tab and select the checkbox for the pend reason. In the instance a line is pending for more than one reason, only one checkbox can be selected. A Note can also be entered and is recommended to explain the reason for the override.
Click the OK button to perform the action selected. Click Revert to undo the action and close the popup.
If the action selected is Override, the Allowed columns become editable. The Allowed Total can be updated to any amount as long as it is not greater than the Requested Total.
If the action selected is Recalc, the Allowed Total will be recalculated using the quantity times the calculated amount for that product row.
If the action selected is Reject, the product row will be rejected and the Allowed Total will be updated to $0.00. It is recommended that a Note be entered when a row is rejected – the detail provided in the note will be used on the reject letters as well as the deduction rebill letters.
After resolving the pendings, click the Save button in the Actions section on the top right of the claim. Click Revert to cancel the updates and the claim will return to the state it was in prior to any updates.
Resolving Hold Lines
If a product or lumpsum row is on Hold for Duplicate Item Submitted, click the reason hyperlink and expand the Note column to see the claim ID with the potential duplicate lines. Compare the lines on both claims to determine if the row is a duplicate. If it is not a duplicate, uncheck the box and click OK to remove the hold from the line. The state of the line will be updated to cleared, pended or rejected.
Edits in View Mode
There are also many updates which can be made to a claim while it is in View mode if the user has Claim Edit rights.
Claim Header
The Claimant Name and Contract Family can be modified. Note that both these fields are hyperlinks. Click the name to view the Company Information.
Claimant Name
Click the Link hyperlink to select a different claimant. This will open the Claimant Search popup. The boxes at the top of each column are filters. In the below example, the Company Name column is filtered to “usf” and all associated records display in the grid. To select a claimant, either double-click on a row and the popup will close and the claimant will be updated with that record.
Or highlight the row and click the Select button. Click Cancel to close the claimant search without making any updates.
Note: All lines that have that same Customer ID on it will also be updated when the change claimant feature is used. If only certain lines need to be updated that request needs to go to the manufacturer email box.
Contract Family
The Contract Family field has 2 edit options - Clear and Link.
Clear
If the Contract selected on the claim is incorrect, but there isn’t a correct contract to assign to that claim, click the Clear option. A Confirmation popup will display. To continue with deleting the linked contract, click Yes. To close the popup and keep the current contract click No Way!
Note that clearing a contract from a claim will update the Claim State to Pending with Claim State Reason of No Contract.
Link
To assign a contract to claim pending for No Contract or to select a different contract click the Link option. This will open up the Contract Search popup. Enter search criteria and click Search or click the Enter key on the keyboard. To select a contract, either double-click the contract row or highlight the row and click Select. After selecting a different contract, the claim will run through the calculate claim process. This could result in claim header states resolving and/or line items resolving and clearing.
Invoice Info
The Deduction Number Hint field can be modified.
Deduction Number Hint – click the Edit option to add or modify this field. Enter in the hint text and click Save. Enter the manufacturer deduction number, if known, or the DOT Foods Reference Number. This field is used as a hint when matching deductions. It does not assign a deduction to the claim.
Product and LumpSum Mass Updates
There are four mass update options available: Recalc, Reject, Override, UnHold
These options are available when in claim view mode. To perform any of these actions, select the checkboxes on the individual rows or use the Select All option. Click Select None to un-check all the boxes.
Note that when performing these mass updates to selected lines that ONLY lines with the selected reasons will be affected.
Scenario 1: there are 3 lines pending for the following reasons: 2 lines for Ineligible Sku and 1 line for Requested Greater than Calculated. Check the boxes for the 2 Ineligible Sku lines and click to Reject with reason code of Ineligible Sku – this will reject ONLY the 2 lines pending for Ineligible Sku.
Scenario 2: there are 4 lines pending for the following reasons: 1 line for Ineligible Sku, 1 line for Requested Greater than Calculated, and 2 lines for Calculated Rate Zero. If ALL rows are selected and then the Mass Override option is selected with reason code Requested Greater than Calculated, ONLY the 1 row pending for that reason will be updated to Override. The other rows will remain pending even though the product rows were checked since they were not pending for the reason code selected.
Mass Recalc
Select this option to recalc lines pending for Requested Greater than Calculated. This is the only pend reason that can be resolved using the Recalc option.
Select the Reason Code and optionally update the text in the claim reason note. Click Commit to update the lines to Recalc for Requested Greater than Calculated. The Allowed Total for the selected rows will be updated to the calculated value times the quantity.
Mass Reject
Select this option to reject any line for any of the pending reasons. The Reason Code dropdown contains a list of all pending reasons – either scroll through the list or start typing in the reason code box to search for the correct reason.
Select the Reason Code and optionally update the text in the claim reason note. Click Commit to update the line to Rejected for the selected reason. The Allowed Total for the rejected rows will update to $0.00.
Mass Override
Select this reason to override the selected lines for the reason code selected. The Reason Code dropdown contains a list of all pending reasons – either scroll through the list or start typing in the reason code box to search for the correct reason.
Select the Reason Code and optionally update the text in the claim reason note. Click Commit to update the lines to Override for the selected reason. The Allowed Total will be updated to equal the Requested Total for the selected lines.
Mass UnHold
Select this option to remove the Hold from any lines pending for Duplicate Item Submitted. Prior to removing the hold, click they reason code hyperlink for the possible duplicate lines and verify that the claim ID(s) listed are not duplicates to the current claim line. The only Reason Code available is Duplicate Item Submitted.
Select the Reason Code and optionally update the text in the claim reason note. Click Commit to remove the hold from the selected lines. These claim will run through the update process and the lines will be updated to either cleared, pended or rejected.
