The claims process, i.e. death, withdrawal, etc. consists of several steps that are required to be completed. These process steps are managed by the system in order to ensure that the necessary information is supplied in order to complete the process correctly.
BENEFIT PAYMENT UPDATE TYPES are used by the system to define the steps in a process. The benefit payment update types displayed are driven by the system, which decides on which ones are required for the type of claim being processed. For example, the benefit payment update types displayed for a death are different to those required for a withdrawal as death claims require beneficiary information. The system will then enforce the capture of data as required by the system. This will also extend to the enforcement of the order of completion of benefit payment update types, e.g. the system will not allow the calculation benefit payment update type to be closed until both the REALIZATION and PAYMENT DETAILS benefit payment update types have been completed, since this data is needed for the calculation.
Some of the benefit payment update types that are displayed may not be mandatory, and the supplying of data is optional, e.g. the PRIOR CLAIM and NOTES benefit payment update types are displayed, may not be applicable to the member. In such cases, the system will not enforce the capture of data.
Adjustments to a benefit are not automatically part of the process. However, if an adjustment is selected by the user, then an Adjust Benefit Payment Update Type will be added to the list of Benefit Payment Update Types.