Claim Detail

processor • Sep 23, 2026, 3:07 PM

submitted CLAIM13823

processor • Sep 23, 2026, 5:23 PM

approved .5

dealer_or_external • Sep 24, 2026, 10:04 AM

@Tessa C @Cole P Approved to order a breaker. Photo is attached in folder.

dealer_or_external • Sep 24, 2026, 10:26 AM

@Stephanie D ON ORDER 18382

dealer_or_external • Sep 25, 2026, 11:44 AM

@Stephanie D SHIPPED UPS

dealer_or_external • Sep 30, 2026, 11:08 AM

@Stephanie D PART HERE CUS ALREADY HAS AN APPOINTMENT MAKE SURE THIS GETS IN THERE

dealer_or_external • Oct 3, 2026, 12:45 PM

WO is in the service folder and noted on the upcoming appt for the customer

processor • Oct 16, 2026, 5:25 PM

TRI 1202 claim 27683 — please review. @Cole P @Stephanie D @Ashlee O @Chris B @Tricia H @Heidi H

processor • Oct 16, 2026, 5:26 PM

What are we supposed to review? This is a test. You should be reveiwing.

processor • Oct 16, 2026, 5:31 PM

UPDATE - CORRECTION: TRI 1202 / K-Z RV / WO 27683 (CLAIM13823). I reviewed WO.pdf, COMPLETED WO.pdf, PA.pdf, and LINE 1.jpg. The work orders report a washer-breaker concern; the completed WO lists breaker #135245 ($56.60) and 0.50 labor hour at $175 ($87.50 labor; $144.10 total). The PA summary shows $0 parts/sublet submitted and approved, with $87.50 labor approved. Please verify whether the $56.60 breaker was submitted and covered. I found no OEM return/denial notice among these four files, so I cannot confirm why the claim is in 7.2. I did not edit or move source files. @Cole P @Stephanie D @Ashlee O @Chris B @Tricia H @Heidi H

processor • Oct 16, 2026, 5:46 PM

@Stephanie D WO 27683 Hey! Was this supposed to be in the #6 folder?

processor • Oct 16, 2026, 6:02 PM

Much better of an answer. @iClaims A

processor • Oct 16, 2026, 6:18 PM

Thanks, Chris. I reviewed the four files in claim 27683 and added the labor/parts comparison plus the missing-return-notice limitation to the correction above. No source files were edited or moved.

processor • Oct 16, 2026, 6:28 PM

Thanks for the clarification. Should this claim be moved to a different folder?

processor • Oct 16, 2026, 6:31 PM

iClaims AI Thanks for the clarification. Should this folder me left here or moved to another folder?

processor • Oct 16, 2026, 6:32 PM

Thanks for the clarification. Should this claim be moved to a different folder?

processor • Oct 16, 2026, 6:51 PM

Thanks for checking. I re-reviewed the full claim packet. I recommend leaving it in 7.2 – Claims Returned for now because the packet doesn’t include an OEM return/denial notice or other direction identifying a different stage. The PA shows $87.50 labor submitted and approved and $0 parts/sublet, while the completed WO lists the $56.60 breaker, so the parts question in the correction still needs confirmation. If the OEM return notice is in another file, please add it and I’ll verify the next folder.

processor • Oct 16, 2026, 7:37 PM

@Tricia H Thanks for checking. I’ve rechecked the claim files and comments. Please leave 27683 in 7.2 – Claims Returned for now; I still don’t see an OEM return or denial notice directing a different stage. The completed work order lists the $56.60 breaker, while the PA summary shows $0 parts approved, so coverage still needs confirmation. If you find the OEM notice, please add it here and I’ll check the next step.

processor • Oct 16, 2026, 8:09 PM

iClaims AI Why would we leave it here when it hasn’t been completed?

processor • Oct 16, 2026, 9:33 PM

UPDATE - CORRECTION: @Chris B , thanks for pointing out the distinction. The repair work is documented as complete, but the claim itself is still returned and unresolved. The PA shows $87.50 labor approved and $0 parts, while the completed work order lists the $56.60 breaker. I found no OEM return notice in the four-file packet. Please keep it in 7.2 – Claims Returned until the return reason and breaker coverage are confirmed. Once corrected and ready to resubmit, move it to 7.3 – Claims Corrected. Tricia, I’m sorry my earlier wording blurred repair completion with claim resolution.

processor • Oct 16, 2026, 9:34 PM

@Tricia H Sorry for the confusion. Please leave 27683 in 7.2 – Claims Returned while we confirm the $56.60 breaker coverage; the PA shows $0 parts approved and the packet contains no OEM return notice. Once corrected and ready to resubmit, move it to 7.3 – Claims Corrected.

processor • Oct 16, 2026, 9:47 PM

@Stephanie D @Cole P @Ashlee O @Heidi H @Emily P

processor • Oct 16, 2026, 9:49 PM

I also understand this is a test and this claim should not be in this folder

processor • Oct 16, 2026, 9:53 PM

iClaims AI What folder should it be in considering since this was a test only?

processor • Oct 16, 2026, 10:44 PM

@Stephanie D, could you please move folder 27683 to the appropriate existing location? It was only a test and is unfinished. Thank you.

dealer_or_external • Oct 17, 2026, 9:08 AM

Yes, our little friend Chris had me do this to try the new AI out! Sorry I should have let you know.

processor • Oct 19, 2026, 11:16 AM

Ah yes...I should have suspected that, haha!

processor • Oct 26, 2026, 12:35 PM

UPDATE - CORRECTION | Testing/Learning | TRI 1202 / WO 27683 REVIEWED ALL FOUR FILES, THE BREAKER PHOTO, AND BOTH WORK-ORDER COMMENT THREADS. STEPHANIE'S OCTOBER 17 REPLY CONFIRMS THIS WAS PLACED IN FOLDER 6 FOR THE AI TEST. MY EARLIER RETURNED-CLAIM/FOLDER-MOVE ADVICE WAS NOT SUPPORTED; FOLDER PLACEMENT DOES NOT ESTABLISH AN OEM RETURN OR FINAL SUBMISSION. THE 3C NARRATIVE SUPPORTS THE WASHER BREAKER DIAGNOSIS: THE FAULT FOLLOWED THE BREAKER DURING THE SWAP TEST, AND REPLACEMENT/TESTING IS RECORDED. THE PHOTO IDENTIFIES THE COMPONENT BUT DOES NOT INDEPENDENTLY PROVE THE ELECTRICAL TEST. PART ORDERING/ARRIVAL IS ALREADY RESOLVED IN THE THREAD. THE COMPLETED WO RECORDS OCTOBER 16, $87.50 LABOR (0.5 HOUR) + $56.60 BREAKER = $144.10. CLAIM13823 PA APPROVES $87.50 LABOR WITH $0 PARTS. BEFORE FINAL BILLING, RECONCILE THE $56.60 PART AGAINST OEM-SUPPLIED VS DEALER-PURCHASED COVERAGE; THIS DIFFERENCE IS NOT A VERIFIED DENIAL OR LOSS. USE THE ACTUAL COMPLETION DATE IN PLACE OF THE PA'S 1/1/0001 PLACEHOLDER. THE COMPLETED WO'S CUSTOMER-SIGNATURE LINE IS BLANK; CONFIRM REQUIRED SIGN-OFF EVIDENCE BEFORE SUBMISSION. LEARNING: DISTINGUISH PREAUTHORIZATION FROM A FINAL CLAIM, MATCH THE PHOTO TO WARRANTY JOB 2 DESPITE ITS 'LINE 1' FILENAME, AND BASE READINESS ON THE COMPLETED PACKET. NO FINAL SUBMISSION RECEIPT OR PAYMENT EVIDENCE WAS FOUND IN THIS PACKET. @Stephanie D @Chris B @Ashlee O @Heidi H @Cole P @Tricia H

processor • Oct 26, 2026, 12:38 PM

UPDATE - CORRECTION | Testing/Learning | TRI 1202 / WO 27683 REVIEWED ALL FOUR FILES, THE BREAKER PHOTO, AND BOTH WORK-ORDER COMMENT THREADS. STEPHANIE'S OCTOBER 17 REPLY CONFIRMS THIS WAS PLACED IN FOLDER 6 FOR THE AI TEST. MY EARLIER RETURNED-CLAIM/FOLDER-MOVE ADVICE WAS NOT SUPPORTED; FOLDER PLACEMENT DOES NOT ESTABLISH AN OEM RETURN OR FINAL SUBMISSION. THE 3C NARRATIVE SUPPORTS THE WASHER BREAKER DIAGNOSIS: THE FAULT FOLLOWED THE BREAKER DURING THE SWAP TEST, AND REPLACEMENT/TESTING IS RECORDED. THE PHOTO IDENTIFIES THE COMPONENT BUT DOES NOT INDEPENDENTLY PROVE THE ELECTRICAL TEST. PART ORDERING/ARRIVAL IS ALREADY RESOLVED IN THE THREAD. THE COMPLETED WO RECORDS OCTOBER 16, $87.50 LABOR (0.5 HOUR) + $56.60 BREAKER = $144.10. CLAIM13823 PA APPROVES $87.50 LABOR WITH $0 PARTS. BEFORE FINAL BILLING, RECONCILE THE $56.60 PART AGAINST OEM-SUPPLIED VS DEALER-PURCHASED COVERAGE; THIS DIFFERENCE IS NOT A VERIFIED DENIAL OR LOSS. USE THE ACTUAL COMPLETION DATE IN PLACE OF THE PA'S 1/1/0001 PLACEHOLDER. THE COMPLETED WO'S CUSTOMER-SIGNATURE LINE IS BLANK; CONFIRM REQUIRED SIGN-OFF EVIDENCE BEFORE SUBMISSION. LEARNING: DISTINGUISH PREAUTHORIZATION FROM A FINAL CLAIM, MATCH THE PHOTO TO WARRANTY JOB 2 DESPITE ITS 'LINE 1' FILENAME, AND BASE READINESS ON THE COMPLETED PACKET. NO FINAL SUBMISSION RECEIPT OR PAYMENT EVIDENCE WAS FOUND IN THIS PACKET. @Stephanie D @Chris B @Ashlee O @Heidi H @Cole P @Tricia H

processor • Oct 26, 2026, 1:34 PM

----TESTING/LEARNING---- UPDATE - CORRECTION | TRI 1202 / WO 27683 REVIEWED ALL FOUR FILES, THE BREAKER PHOTO, AND BOTH WORK-ORDER COMMENT THREADS. STEPHANIE'S OCTOBER 17 REPLY CONFIRMS THIS WAS PLACED IN FOLDER 6 FOR THE AI TEST. MY EARLIER RETURNED-CLAIM/FOLDER-MOVE ADVICE WAS NOT SUPPORTED; FOLDER PLACEMENT DOES NOT ESTABLISH AN OEM RETURN OR FINAL SUBMISSION. THE 3C NARRATIVE SUPPORTS THE WASHER BREAKER DIAGNOSIS: THE FAULT FOLLOWED THE BREAKER DURING THE SWAP TEST, AND REPLACEMENT/TESTING IS RECORDED. THE PHOTO IDENTIFIES THE COMPONENT BUT DOES NOT INDEPENDENTLY PROVE THE ELECTRICAL TEST. PART ORDERING/ARRIVAL IS ALREADY RESOLVED IN THE THREAD. THE COMPLETED WO RECORDS OCTOBER 16, $87.50 LABOR (0.5 HOUR) + $56.60 BREAKER = $144.10. CLAIM13823 PA APPROVES $87.50 LABOR WITH $0 PARTS. BEFORE FINAL BILLING, RECONCILE THE $56.60 PART AGAINST OEM-SUPPLIED VS DEALER-PURCHASED COVERAGE; THIS DIFFERENCE IS NOT A VERIFIED DENIAL OR LOSS. USE THE ACTUAL COMPLETION DATE IN PLACE OF THE PA'S 1/1/0001 PLACEHOLDER. THE COMPLETED WO'S CUSTOMER-SIGNATURE LINE IS BLANK; CONFIRM REQUIRED SIGN-OFF EVIDENCE BEFORE SUBMISSION. LEARNING: DISTINGUISH PREAUTHORIZATION FROM A FINAL CLAIM, MATCH THE PHOTO TO WARRANTY JOB 2 DESPITE ITS 'LINE 1' FILENAME, AND BASE READINESS ON THE COMPLETED PACKET. NO FINAL SUBMISSION RECEIPT OR PAYMENT EVIDENCE WAS FOUND IN THIS PACKET. @Stephanie D @Chris B @Ashlee O @Heidi H @Cole P @Tricia H

processor • Oct 26, 2026, 2:42 PM

submitted CLAIM13823