Claim Batches List

1. What does this feature do? (High-Level Overview)

This feature shows generated claim batches and helps billing users manage each batch through the full handoff flow. It reduces manual tracking by centralizing search, review, sending to ClaimMD, download, and deletion actions in one list.

2. Who is this for? (Roles & Permissions)

• Users with manage_claims (Manager, Owner): Can view the list and use batch actions (send, view EDI, download, delete, and re-create for rejected batches).

3. Business Rules & Enforcements

• Rule 1: Claim batches are scoped by location access on the backend, and the list can also be filtered by the active location context.
• Rule 2: A batch can be sent only when there is at least one active clearing house configured for that batch location.
• Rule 3: If multiple active clearing houses exist, the user must select one before sending.
• Rule 4: If eligibility validation returns rejected claim status/messages, the batch is marked as rejected and is not moved to sent.
• Rule 5: If sending succeeds, the batch status becomes sent and related notes are marked as billed.
• Rule 6: Deleting a batch removes it from this system; if it was already sent/rejected, the warning clarifies this does not remove it from ClaimMD.

4. UI Placement

1. Reports > Billing Collections > Batches: Entry point to the claim batches list.
2. Claims page (/claims): Main list with filters, sorting, pagination, statuses, and actions.
3. EDI Viewer (/claims/edi-viewer/:id): Opened from the list to inspect batch EDI details.

5. How-To Guide (Step-by-Step)

Scenario A: Send a pending batch to ClaimMD

1. Open Reports > Billing Collections > Batches.
2. Use filters if needed (Filename, CPT Code, Patient, Provider, Insurance), then click Search.
3. Find a row with pending status and click the send icon.
4. Confirm the action. If prompted, choose a clearing house connection.
5. Review the result:
6. If successful, the batch moves to sent.
7. If eligibility fails, the batch moves to rejected with a rejection reason available in the status tooltip.

Scenario B: Review and export a batch

1. Locate the target batch in the list.
2. Click the eye icon to open the EDI Viewer and inspect transaction details.
3. Return to the list and click the download icon to export the EDI file.
4. If the batch should be removed from the app record, click the trash icon and confirm deletion.

6. What happens if…? (Edge Cases / FAQ)

• Q: What happens if the location has no active clearing house connection?
  A: Sending is blocked and the user receives an error indicating no active clearing house is configured.
• Q: What happens if more than one active clearing house exists for the location?
  A: The user must select which connection to use before the batch can be sent.
• Q: Can a sent batch still be deleted from this list?
  A: Yes. The batch can be deleted from this system, but this does not remove the already submitted batch from ClaimMD.