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ClaimDenialReason

Why a claim, or part of a claim, is denied. New values can be added; handle an unknown value without failing.

enum ClaimDenialReason {
  CLAIM_AMOUNT_RECEIPT_AMOUNT_MISMATCH
  CLAIM_DATE_RECEIPT_DATE_MISMATCH
  CLAIM_OUTSIDE_OF_PLAN_YEAR
  DEPENDENT_NOT_COVERED
  INELIGIBLE_EMPLOYEE
  INELIGIBLE_EXPENSE
  OTHER
  RECEIPT_MISSING_OR_INVALID
  UNSPECIFIED
}

Values​

ClaimDenialReason.CLAIM_AMOUNT_RECEIPT_AMOUNT_MISMATCH​

The claim amount does not match the amount on the receipt.

ClaimDenialReason.CLAIM_DATE_RECEIPT_DATE_MISMATCH​

The claim date does not match the date on the receipt.

ClaimDenialReason.CLAIM_OUTSIDE_OF_PLAN_YEAR​

The expense falls outside the Benefit's plan year.

ClaimDenialReason.DEPENDENT_NOT_COVERED​

The claimant is not covered by the Benefit.

ClaimDenialReason.INELIGIBLE_EMPLOYEE​

The Individual is not eligible for the Benefit.

ClaimDenialReason.INELIGIBLE_EXPENSE​

The expense is not eligible for the Benefit.

ClaimDenialReason.OTHER​

Another reason, described in the comment.

ClaimDenialReason.RECEIPT_MISSING_OR_INVALID​

The receipt is missing or not valid.

ClaimDenialReason.UNSPECIFIED​

No reason was recorded. Appears only on some earlier claims, and is not accepted as input.

Member Of​

ClaimDenial object ● ClaimDenialInput input ● DenyClaimInput input