This shows you the differences between two versions of the page.
| Both sides previous revision Previous revision Next revision | Previous revision | ||
|
oem_claim_denied [2016/07/26 13:25] 192.168.9.146 |
oem_claim_denied [2019/01/05 22:10] (current) |
||
|---|---|---|---|
| Line 1: | Line 1: | ||
| - | ====== Claim OEM Denied ====== | + | ====== Claim Manufacturer Denied ====== |
| - | The manufacturer has denied the consumers claim form. You as the provincial administrator will need to review and make a final decision. | + | The manufacturer has denied the consumers claim form. |
| + | |||
| + | You as the provincial administrator will need to review and make a final decision. | ||
| * Select the **claim number** or the **Claim OEM Denied** button | * Select the **claim number** or the **Claim OEM Denied** button | ||
| **NOTE:** They show slightly different things, but give you the same functionality. | **NOTE:** They show slightly different things, but give you the same functionality. | ||
| Line 8: | Line 10: | ||
| Here you will be able to view the claim form, documents and reason for denial. | Here you will be able to view the claim form, documents and reason for denial. | ||
| ===== Select Claim OEM Denied Button ===== | ===== Select Claim OEM Denied Button ===== | ||
| - | Here you will see a summary of the problem(s) and document(s) available. | + | Here you will see a __summary__ of the problem(s), document(s) and communication available, along with the reason for denial. |
| - | ====== Actions ====== | + | ===== Actions ===== |
| - | You will notice you still have the [[Reassign Arbitrator|Reassign Arbitrator]] button and you now have a new one, which is [[Request Technical Inspection|Request Technical Inspection]]. | + | You will notice you still have the [[Reassign Arbitrator]] button and you now have a new one, which is [[Request Technical Inspection]]. |
| - | ====== Statuses ====== | + | ===== Statuses ===== |
| There are a number of options for handling the denial, select the appropriate one. | There are a number of options for handling the denial, select the appropriate one. | ||
| {{::change_status_claim_oem_denied.png|}} | {{::change_status_claim_oem_denied.png|}} | ||
| - | * [[Eligibility Hearing Required]]: The manufacturer does not believe the claim is eligible, but the PA believes there is value in investigating the claim further by having a hearing and involving the arbitrators opinion at this point. | + | * [[Eligibility Hearing Required]]: The manufacturer does not believe the claim is eligible, but the PA believes the consumer meets the CAMVAP eligibility requirements and schedules an eligibility hearing. |
| - | * [[Closed|Closed Claim Ineligible]]: Based upon the review of the information provided the claim is considered ineligible and will be closed. | + | * A [[Letters|manual letter]] should be sent to consumer, manufacturer and arbitrator outlining why an eligibility hearing has been scheduled and the hearing details. |
| + | |||
| + | * [[Closed|Closed Claim Ineligible]]: Based upon the review of the information provided by the manufacturer the claim is considered ineligible and will be closed. | ||
| + | * A [[Letters|manual letter]] should be sent to consumer and manufacturer indicating that the claim has been closed and why. | ||
| * [[Closed|Closed Conciliated]]: The consumer and the manufacturer have come to an agreement prior to arbitration. | * [[Closed|Closed Conciliated]]: The consumer and the manufacturer have come to an agreement prior to arbitration. | ||
| + | * A [[Letters|manual letter]] should be sent to consumer, manufacturer and arbitrator indicating that the claim has been closed and why. | ||
| + | |||
| * [[Closed|Closed Withdrawn]]: The consumer has decided to remove their case from the arbitration process | * [[Closed|Closed Withdrawn]]: The consumer has decided to remove their case from the arbitration process | ||
| - | Provide additional notes as you see fit and save the status change {{::status_notes.png|Status Notes}} | + | * A [[Letters|manual letter]] should be sent to consumer, manufacturer and arbitrator indicating that the claim has been closed and why. |
| - | **NOTE:** Once the status change has been made it cannot be altered. | + | |
| + | |||
| + | Provide additional notes as you see fit and save the status change. Please use caution when recording claim notes as all parties have access to the notes. | ||
| + | {{::status_notes.png|Status Notes}} | ||
| + | NOTE: Once the status change has been made it cannot be altered. | ||
| - | **ARLENE TO UPDATE** | ||
| - | * A **[[Letter Templates|automated letter]]** will be sent to X, X, and X. | ||
| - | * A **[[Letters|manual letter]]** should be sent to X, X, and X. | ||
| - | **END UPDATE** | ||