EDI LIMNET Bulk Claims

EDI LIMNET supports the handling of bulk claims messages. A bulk claim consists of a bulk header and a number of bulk component claims. The bulk header is created as a claim in its own right, but there is a new indicator on Claim windows that shows the claim is a bulk header. Claims where the EDI bulk claim check box (on the Section Specific tab) is selected must have a claim disposition of Informational. Like other informational claims in SICS, no claim adjustments are transferred to the Business Ledger.

Each component claim also exists as a separate claim within SICS (usually the component claims are created before the bulk header.) These component claims are for the most part just like any other claim created and handled by EDI.

When any claim adjustments are made as a result of a bulk message, the bulk header UCR is added to the booking details on the ledger for each component. Any claim payment is booked as an Advised Claim Payment.

Subsequently when the corresponding bulk claim signing is received, it is referenced to the bulk header claim. Using the bulk UCR reference on the ledger, the claim bookings from the signing are made to each individual component claim, not the bulk header. These bookings consist of a reversal of the Advised Claim Payment, and rebooking using a Claim Paid entry code. These rebooking use the standard London Reference (stamp number and signing number.)

When the settlement message is processed, it pairs against all the claim signings with the same London Reference.