Send communication to NPHIES

Send attachments, clarifications or more information about a claim or prior authorization. A check mark shows a completed section.

This screen answersUS-37 US-38 OP-7

Acceptance criteria

US-37 Communications 6-Tab Load LOW

As a user, I want per-tab completion indicators and visible linked-record context in Communications, so that composing a message is less awkward.

Per-tab completion checkmarks added.
Linked-record context visible while composing.

US-38 Wizard Navigability LOW

As a user filling long wizards, I want to save a draft and resume, plus jump between completed steps, so that I don't lose work on long forms.

Persistent step indicator with jump-to-completed-step.
Save-as-draft + resume across Eligibility, Pre-Auth, Claims.
No partial submission to NPHIES from a draft.

OP-7 Permission matrix fixes P1 OPERATIONAL REVIEW

As an administrator, I need the permission matrix to match daily work, so people can do their job and no more.

A/R can read the status checker and reply on messages linked to a claim it chases.
Delete means a draft of your own, never a submitted record. Submitted records are cancelled.
An override above a threshold needs a second person in a later release. The override screen says so.

Wireframe state

DefaultUnsaved changes

Leave without saving?

This message has unsaved changes. If you leave, they are lost.

Save draft and leave Leave without saving Stay on page

Message detailsAbout and reply targetPatient detailsContent and attachmentsNotes

Message details

Recipient organization (payer)

Provider type

Required for an unsolicited communication.

Priority

Reason code (optional)

About and reply target

About reference

The claim or authorization this message is about.

About type

A/R can send communications about a claim only. Prior authorization messages stay with the approval officer.

Based on communication request (optional)

Select the inbound payer request you are replying to.

Based on communication request bundle ID (optional)

Use this when replying to a payer request.

Patient details

Find patient (optional)

Pick a patient to fill in the details, or enter them below.

Patient ID

Patient ID type

First name

Middle name (optional)

Last name

Date of birth

Marital status

Gender (optional)

Occupation

Phone number (optional)

Content and attachments

Attachment

lab-report-28sep.pdfPDF, JPG, PNG, DOC, DOCX, XLS or XLSX.Choose file

Text content (Optional)

Message (optional)

Add text if you are not attaching a file, or to add detail.

Claim item sequence (optional)

Select the claim item this communication refers to.

Resource reference Optional. Link an existing FHIR resource

Reference (optional)

FHIR reference to an existing resource related to this communication.

Reference display (optional)

Optional human-readable description of the referenced resource.

Notes

Request note (optional)

Cancel

Clear form Save draft Send communication

Linked record

Claim: CL-20418
Patient: Noura Al Harbi
Payer: Bupa Arabia
Status: Denied
Amount: SAR 950.00