Note: Split Coding for Transactions and Payments is optional. If your company has elected to use this feature, the system setting "Allow Split Transactions" in the Diamond System Editor: Claims / Transaction folder must be set to "True" (Enable). You must also have the authority, "Add Split Transaction," (Claim Transaction group) to do this function.
Split coding for payments and transactions allows claim adjusters to select a claimant and have all features and coverages with their current reserves display on one (1) screen for selection to issue a payment or transaction. It then allocates portions of the payment amount to multiple features / coverages and sub coverages. The sums of those portions equal the one (1) claim payment total amount. This populates the check or the reserve change total amount equal to the sum of the feature / coverage reserve change total.
Claim transactions entered through the Claim Split Transaction screen are saved in the same way a single transaction is. Each feature level transaction is saved separately, but maintains a link to the grouped claimant level transaction information. Reserve validations and user authority limit validations are performed the same as if processing a single transaction.
This Help File includes:
Transaction information cannot be added to a claim until claimant / feature information has been entered and saved.
In the left pane of the Claim Tree View, highlight the feature / coverage for which the split transaction is being opened.
Click Add Split Transaction.
When the Transaction screen displays:
Category: Select the transaction classification from the combo box.
Type: Depending on the category chosen, the type of transaction may default.
Tracking: Choose a tracking type from the combo list.
Transaction Remark: Enter a brief narrative regarding the transaction.
Amount: Enter the dollar amount of the transaction.
Split Transaction: Once a dollar amount is entered, the Split Transaction button displays. Click Split Transaction. This returns the Claim Split Transaction screen.
On the Claim Split Transaction screen, for each feature requiring an amount:
Claim Feature: Select the feature from the combo box.
Amount: Defaults to zero (0). Use the <TAB> key to move to the Amount field; enter a dollar amount.
Deductible Check Box: If the deductible is being applied, click in the check box opposite the amount field.
Deductible (Amount): Display field only. If a check mark is placed in the Deductible Check Box, the deductible minus (-) the amount entered displays.
Target: Defaults to zero (0). When a dollar amount is entered for the transaction, the target amount displays that same amount.
Once all entries and selections are made, click Save. When the Transaction screen returns, a message is displayed in red: "This transaction is part of a split transaction with a total amount of <Dollar Amount>."
If all entries are correct, you are now ready to make the payment.
On the Transaction screen, select the Payment Type from the combo box.
A Payee / Mail-To must be designated. At the bottom of the screen, a payee / mail to is required for submitting the transaction.
Depending on your company's implementation, you may or may not have payees / mail to's listed in this section. (Note: These are defined by system settings in Diamond System Editor under the Claims / Transactions / Payee folder.)
The Payee Info section contains three (3) buttons:
Add: Select to add a payee / mail to.
Edit: Highlight an existing payee / mail to and click Edit to change any information.
Delete: Highlight an existing payee / mail to and click Delete to remove an existing payee / mail to.
You are also required to have a "Pay to the Order Of" on a transaction.
Add All Payees: Select to add all payees listed in the Payee / Mail To section of the screen. These are then shown in the list view.
Build: Select to return the Build Pay to the Order Of screen. You may then selectively add one (1) or all payees as those being paid on the transaction by highlighting an individual in the top of the screen an clicking Add Payee. Repeat for each person you want as a "Pay to the Order Of." When finished, click Build Pay to the Order Of to place the individuals in the bottom of the screen.
View: Only after you have added a "Pay to the Order Of," click View to show who the transaction is being paid to. It returns a Pay to the Order Of screen with the name or the names that will be listed on the transaction.
Select the Issue button on the Transaction tab toolbar and answer Yes to the question: "Issue this transaction?" Access the claimant's folder in the Claim Tree View and open each of the Transactions folders. The split transaction payment displays.
Note: Any transaction that is a "Split Transaction" is displayed with an "(S)" in front of it. Single transactions do not have any type of indicator.
Other options on the Claim Split Transaction screen toolbar include:
Save: Retains all entries and selections made; returns the Transaction screen. A message is displayed in red: "This transaction is part of a split transaction with a total amount of <Dollar Amount>."
Cancel: Select to exit the screen; entries not retained when you answer Yes to the question: "Cancel and lose all split allocations?"
Modify Data:
Clear Data Row: Highlight a claim feature and select Clear Data Row; removes the feature and corresponding amount.
Reset All Data: Clears all claim features and amounts from the screen.
At the bottom of the screen, the following fields include:
Split Total: Defaults to zero (0). As an amount is entered for each transaction, the amount is added to this field.
Difference: Defaults to the transaction amount entered on the Transaction screen. As an amount is entered for each claim feature, that amount is subtracted from this field and added to the Split Total field.
Transaction Amount: Defaults to the transaction amount entered on the Transaction screen.
Target Total: Defaults to zero (0). As amounts are entered, each amount is added to this field.
Adjust: If the amount on the Claim Split Transaction screen is different than the amount originally entered on the Transaction screen, select the Adjust button to correct the total.