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Ailaaj Academy

Run a claims day

Goal

By the end of this tutorial you will have cleared at least one pending claim from the queue using the real Claims Management screens.

1. Open the dashboard

Go to Claims Management → Dashboard. Check Pending Claims and skim the Pending Queue.

Claims dashboard with KPIs and pending queue
Start here — pending count and the short queue.

2. Open the full claims list

Click View all on the pending queue, or go to Claims Management → Claims. Filter to Submitted if you only want new work.

Claims list filtered for work
Claims list — status chips and filters.

3. Open a claim

Click a row. Review the summary, attachments, advisories, and available allowance.

Claim detail ready to process
Claim detail — eligibility context before you decide.

4. Process the claim

Click Process Claim. Choose Approve, Partial, Reject, or Request Info. Confirm the amount (and a note if advisories warn you), then Submit Decision.

Process Claim decision dialog
Decision dialog — approve, partial, reject, or request info.

5. Confirm

The claim status updates, member balance adjusts when you approve/partial, and the audit history records your decision. Return to the list — the row should leave the pending chips.

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