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Facility A

This screen answersUS-26 US-33 US-35 US-38 OP-1 OP-4 DS-8

Acceptance criteria

US-26 Soft Workflow Sequencing LOWEST

As a user, I want optional non-blocking guidance to the next logical module, so that the workflow is clearer without being forced.

After Eligibility → non-blocking suggestion to proceed to Pre-Auth for same patient.
Ignoring it blocks nothing.

US-33 Poll NPHIES State Bug HIGH

As a user polling NPHIES, I want a clean, accurate poll state, so that I don't see a stale success and a failure at the same time.

New poll attempt clears the prior result block before rendering.
"Last polled at" timestamp shown.
Failed + success blocks never render simultaneously.

US-35 Read-Only Module Banners LOW

As a user, I want a clear receive-only banner on read-only modules, so that I understand why there's no Create action.

Advanced Auth + Payment Reconciliation show a receive-only banner explaining no Create path.

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-1 Role work queues P1 OPERATIONAL REVIEW

As a desk user, I need named queues for my role with an ageing column, so I see what to do next without searching.

Queues: Ready to bill, Rejected, Expiring soon, Payer questions, Queued, My drafts. Each shows the days since service, submission or rejection.
Home tiles open the queue for the role. Counts match the list.
Queues are shared inside the role and the facility. A queue can be filtered to My work.

OP-4 Background NPHIES poll P1 OPERATIONAL REVIEW

As the system, I poll NPHIES on a schedule, so answers and payer-issued authorizations are not missed.

Task poll shows the schedule, the last poll and the next one. Poll now stays as a fallback.
Every page shows the last poll in the top bar. A failed poll says so in the top bar.
New answers land in the Inbox. The administrator sets the interval (confirm the allowed rate on the NPHIES IG).

DS-8 Source badge, lookup and health on daily screens P1 ADDED BY SCOPE: DATA SOURCES

As a desk user, I need to find a patient, practitioner, service, payer or diagnosis from the hospital system while I work, and to know when it is not available, so I keep working.

Pickers offer Find in hospital system. Records from a source carry a source badge and a reference id, show source fields read only and offer Refresh from source.
When the source is down a banner says so. Last known data may be shown where allowed. Creating a request for that entity is blocked or allowed with manual entry, as the per entity fallback setting says.
Roles that can read Data sources see a source health indicator in the top bar and on Home.

Wireframe state

DefaultEmptyIdle warningMaintenance soonNPHIES downPoll failedSource down

Planned maintenance. RaneemHCP is down for maintenance on 10 Oct 2026, 22:00 to 23:00. Save your work before then.

What this means

NPHIES is not answering. Your requests are saved and will be sent when NPHIES is back.

See saved requests Save a claim

The last NPHIES poll failed. NPHIES did not answer at 09:30. The next automatic poll runs at 09:45. Poll again now, or ask an administrator.

Poll again

At a glance

Claims

212

This month

Approved claims

163

77% of claims

Prior authorizations

Used by your claims

Your queues

Ready to bill

Approved visits that have no claim yet

Denied

Claims a payer denied

Payer questions

Messages that wait for your answer

Queued

Waiting for NPHIES, or saved while NPHIES was down

My drafts

Saved in RaneemHCP, not sent to NPHIES

Pick up where you left off

Drafts

Claim
Diagnosis step, 04 Oct 2026, 17:20

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Needs attention

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Tasks4
Failures1
Responses6
Messages2

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Latest from your Inbox

See all

Item	Status	When
Claim CL-20418Denied: member not covered	Denied	05 Oct 2026, 09:31
Authorization PA-10977Expires on 17 Oct 2026	Expiring soon	05 Oct 2026, 09:00
Eligibility EL-30551Waiting for the payer	Pending	05 Oct 2026, 09:12
Advanced Authorization APA-0412Payer started a request	Received	05 Oct 2026, 08:40

Outcome breakdown

Claims

Approved 163, Pending 30, Denied 19

Nothing needs attention

You have no saved drafts and no new items. Forms you start are saved here.

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