Create Claims XML Information

This is a process that allows your company to create claims XMLs and process subrogation notes to send and retrieve from a 3rd Party vendor.

Files can be created "manually" or "automatically" via a process in End of Day Processing, "Create Claims XML."

Step 1: Pre-Implementation

System Settings: If your company is "Manually" creating the XML files via Diamond Administration / Claims / Create Claims XML function, you will need to define the locations where the XMLs that are created and the directory for where the returned subrogation notes (also created in Diamond Administration / Claims / Process Subro Notes) are held. This is done in the Download folder, using the "XML to Path" system setting.
System Settings: In the Claims / Create Claims XML folder, set up the system settings in the table below if your company is creating the files "Automatically." (These files are automatically created when the Create Claims XML Process is configured in End of Day Processing.)

Field	Function / Value	Options	Default
Create Claims XML for All Claims	Determines if End of Day Processing should create XMLs for all claims. This is in addition to the Number of Days Run.	False = No XMLs are created. True = The EOD Process, Claims XML, will create XMLs for all claims.	False = No XMLs are created.
Export Path	Determines the path where the claim XMLs will be written.	Implementation Specific; user defined.	c:\temp\claims xml
Export Path - All	The path where the claim XMLs will be written when Create XMLs for All Claims is selected.	Implementation Specific; user defined.	c:\temp\claims xml all
Number of Days	Determines the number of days used during the EOD process to create Claims XMLs. XMLs will be created for claims with a reported_date within this number of days.	Implementation Specific; user defined.	7

Step 2: Diamond Administration / Claims / Create Claims XML

This function is used to "manually" create XML files that will be sent to a 3rd party vendor.

Company: Select from the combo box.
Number of Previous Days (-1 for All): This field determines how far back (how many days prior to today) that the process should go to create the XMLs. The process uses the reported date of the claim and only retrieves claims within the previous number of days entered. For example, if today's date is 05/15/2013 and the Previous Days is set to "5," XMLs will be created for all claims reported between 05/10/2013 and 05/15/2013. If the Previous Days field is set to "-1," XMLs will be created for claims reported on all previous days.

Once the XML files have been created, the system returns a validation: "The claim XMLs have been created." These are held in the "XML Path" system setting identified in the Download folder until they are manually transmitted by the carrier.

Automatically Create XML Files

If a carrier chooses to automate this process rather than doing it "manually" through Diamond Administration, they can configure an End of Day job:

Diamond System Editor: Make sure the system settings are set up as outlined above.
End of Day Processing: Set up the "Create Claims XML" process in your End of Day Configuration.

Once the files are written out to the XML path identified in the system setting, the carrier then manually transmits the files to their 3rd party vendor.

Step 3: Diamond Administration / Claims / Process Subro Notes

To import the information and create the subro notes (both created "manually" and "automatically"):

Browse: To the directory where the files are transmitted to.
Highlight the file; click Open.
Process Subro Notes: Select

Once the subrogation notes have been processed, Diamond returns a validation: "The subro notes have successfully been imported." The Subrogation Notes are attached to the appropriate claims.