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Claims and financial finalization · VERSION 664f6a8f

Review a held claim and understand a draft-invoice refusal

Inspect an initial claim’s actual invoice link, request Review existing invoice tax, and read the refusal while the invoice remains Draft. The example preserves all eight claim edits and never confirms finalization or sends a claim.

Facility Admin · RCM · Finance

Locate Review on the selected held case. Genuine wide MANSOQ screen with fictional local training records.123
Recorded release 664f6a8f · 2026-10-19T02:59:13.295143+00:00 · 1728 × 921

Locate Review on the selected held case

Capture details

Exact committed 664f source, local isolated synthetic Clinic. Existing non-staff, non-superuser Clinic administrator. Source and 139 frontend assets were verified independently. This is local teaching, not production deployment, payer acceptance, legal authority or tax approval.

Image SHA-256 6a0444ec76727f5df12eabc65e8df36ac75eadbcd73340fa71e00708964d94c8

  1. Review existing invoice tax: This requests a review of existing financial evidence.
  2. Eight edits remain: The claim remains held.
  3. Local failed eligibility records: These validation failures are not payer approval or evidence of a transport attempt.
Read the actual draft-invoice review refusal. Genuine wide MANSOQ screen with fictional local training records.123
Recorded release 664f6a8f · 2026-10-19T02:59:23.623193+00:00 · 1728 × 921

Read the actual draft-invoice review refusal

Capture details

Exact committed 664f source, local isolated synthetic Clinic. Existing non-staff, non-superuser Clinic administrator. Source and 139 frontend assets were verified independently. This is local teaching, not production deployment, payer acceptance, legal authority or tax approval.

Image SHA-256 16de424e5697bcd36be69cd375ddf55997a96ff7cbcca536d135e55b26fa9053

  1. Scope or status refusal: The actual code is CANONICAL-INVOICE-SCOPE-MISMATCH. In this verified example the invoice is still Draft with no issue date.
  2. Review remains available: No eligible confirmation dialog is opened.
  3. View current claim evidence: Return to the pure claim evidence surface.

11 of 11 content blocks have reviewed image alignment. Missing overview or prerequisite images remain open.

Before you begin

  • Use an existing authorized account with account-read and invoice-write access. The selected fictional episode already has one saved draft invoice and one initial local claim. Its retained clinical and commitment prerequisites are separate from tax and payer qualification.
    Read the new invoice-linked held claim. Genuine wide MANSOQ screen with fictional local training records.123
    Recorded release 664f6a8f · 2026-10-19T02:58:47.992741+00:00 · 1728 × 921

    Read the new invoice-linked held claim

    Capture details

    Exact committed 664f source, local isolated synthetic Clinic. Existing non-staff, non-superuser Clinic administrator. Source and 139 frontend assets were verified independently. This is local teaching, not production deployment, payer acceptance, legal authority or tax approval.

    Image SHA-256 4e7c1abd754ca6750464164d8c4a79aa33151c0cc4ca3cf68b5d786bd02e97de

    1. Actual invoice link: The new local claim references the saved draft invoice.
    2. Draft tax pending: The claim remains held, not externally accepted.
    3. Not submitted: No payer submission is represented.
    Locate Review on the selected held case. Genuine wide MANSOQ screen with fictional local training records.123
    Recorded release 664f6a8f · 2026-10-19T02:59:13.295143+00:00 · 1728 × 921

    Locate Review on the selected held case

    Capture details

    Exact committed 664f source, local isolated synthetic Clinic. Existing non-staff, non-superuser Clinic administrator. Source and 139 frontend assets were verified independently. This is local teaching, not production deployment, payer acceptance, legal authority or tax approval.

    Image SHA-256 6a0444ec76727f5df12eabc65e8df36ac75eadbcd73340fa71e00708964d94c8

    1. Review existing invoice tax: This requests a review of existing financial evidence.
    2. Eight edits remain: The claim remains held.
    3. Local failed eligibility records: These validation failures are not payer approval or evidence of a transport attempt.
  • The recorded initial claim was created through the supported API build action with the actual saved invoice reference. The case page’s Build claim control sends an empty body in this release; it does not perform that explicit invoice selection. This guide begins at the saved linked result. The unpictured API-client invocation remains a separate teaching gap.
    Read the new invoice-linked held claim. Genuine wide MANSOQ screen with fictional local training records.123
    Recorded release 664f6a8f · 2026-10-19T02:58:47.992741+00:00 · 1728 × 921

    Read the new invoice-linked held claim

    Capture details

    Exact committed 664f source, local isolated synthetic Clinic. Existing non-staff, non-superuser Clinic administrator. Source and 139 frontend assets were verified independently. This is local teaching, not production deployment, payer acceptance, legal authority or tax approval.

    Image SHA-256 4e7c1abd754ca6750464164d8c4a79aa33151c0cc4ca3cf68b5d786bd02e97de

    1. Actual invoice link: The new local claim references the saved draft invoice.
    2. Draft tax pending: The claim remains held, not externally accepted.
    3. Not submitted: No payer submission is represented.
    Read one held claim behind the draft invoice. Genuine wide MANSOQ screen with fictional local training records.123
    Recorded release 664f6a8f · 2026-10-19T02:59:52.579585+00:00 · 1728 × 921

    Read one held claim behind the draft invoice

    Capture details

    Exact committed 664f source, local isolated synthetic Clinic. Existing non-staff, non-superuser Clinic administrator. Source and 139 frontend assets were verified independently. This is local teaching, not production deployment, payer acceptance, legal authority or tax approval.

    Image SHA-256 9880e6f300d60b5c4421c45d47605d729132e0bf73794bd77ec946b58cab55f2

    1. One linked claim: The invoice now references one local initial claim.
    2. Held initial claim: The linked claim is draft_tax_pending.
    3. Local patient amount is not collectable approval: The screen’s adjudicated-share caption does not establish adjudication for this still-held draft.

1. Check the linked claim’s state

Open the selected claim evidence. Check the claim identifier, encounter and Local Invoice link. In this example the new claim references the actual saved draft, its processing outcome is draft tax pending, and it is not submitted or adjudicated. Invoice linkage is not payer acceptance.

Read the new invoice-linked held claim. Genuine wide MANSOQ screen with fictional local training records.123
Recorded release 664f6a8f · 2026-10-19T02:58:47.992741+00:00 · 1728 × 921

Read the new invoice-linked held claim

Capture details

Exact committed 664f source, local isolated synthetic Clinic. Existing non-staff, non-superuser Clinic administrator. Source and 139 frontend assets were verified independently. This is local teaching, not production deployment, payer acceptance, legal authority or tax approval.

Image SHA-256 4e7c1abd754ca6750464164d8c4a79aa33151c0cc4ca3cf68b5d786bd02e97de

  1. Actual invoice link: The new local claim references the saved draft invoice.
  2. Draft tax pending: The claim remains held, not externally accepted.
  3. Not submitted: No payer submission is represented.

2. Read the remaining edits and line evidence

Read all eight validation edits, then the line’s Original Charge, Contractual Allowed and Tax Decision columns. The charge gross is SAR 200 and the local claim allowed amount is SAR 150. The screen labels the legacy ledger columns as unstated, and its tax reference is unestablished; do not infer a legal tax amount from these numbers.

Read the new claim’s eight remaining edits. Genuine wide MANSOQ screen with fictional local training records.123
Recorded release 664f6a8f · 2026-10-19T02:58:51.633672+00:00 · 1728 × 921

Read the new claim’s eight remaining edits

Capture details

Exact committed 664f source, local isolated synthetic Clinic. Existing non-staff, non-superuser Clinic administrator. Source and 139 frontend assets were verified independently. This is local teaching, not production deployment, payer acceptance, legal authority or tax approval.

Image SHA-256 1558aef92ec8e98191c9380daef8360d7e3f8b983bbdb40747e76275e9b3eea9

  1. Tax still unresolved: Invoice linkage does not satisfy the tax hold.
  2. Estimate not presented: A separate estimate requirement remains open.
  3. SBS coding remains required: The authored local vocabulary is not an official billing terminology licence.
Separate charge gross, allowed money and tax reference. Genuine wide MANSOQ screen with fictional local training records.123
Recorded release 664f6a8f · 2026-10-19T02:58:57.139855+00:00 · 1728 × 921

Separate charge gross, allowed money and tax reference

Capture details

Exact committed 664f source, local isolated synthetic Clinic. Existing non-staff, non-superuser Clinic administrator. Source and 139 frontend assets were verified independently. This is local teaching, not production deployment, payer acceptance, legal authority or tax approval.

Image SHA-256 a6ab07a55cd05a6120ac465b902a0083269f42d9628ffce13e7b9d8cdd2b000d

  1. Original gross SAR 200: The original captured charge remains separate from the claimed allowed amount.
  2. Allowed SAR 150: Read the column’s own unestablished-state warning as well as its number.
  3. Tax reference unestablished: A line reference must not invent or duplicate claim-level tax.

3. Locate the selected case’s Review control

With the intended fictional Revenue Cycle case open, find its matching held claim under Claims and NPHIES status. The Link existing claim finances panel explains the separate tax-projection and claim checks. Select Review existing invoice tax once. This is a review request, not a financial-finalization confirmation.

Locate Review on the selected held case. Genuine wide MANSOQ screen with fictional local training records.123
Recorded release 664f6a8f · 2026-10-19T02:59:13.295143+00:00 · 1728 × 921

Locate Review on the selected held case

Capture details

Exact committed 664f source, local isolated synthetic Clinic. Existing non-staff, non-superuser Clinic administrator. Source and 139 frontend assets were verified independently. This is local teaching, not production deployment, payer acceptance, legal authority or tax approval.

Image SHA-256 6a0444ec76727f5df12eabc65e8df36ac75eadbcd73340fa71e00708964d94c8

  1. Review existing invoice tax: This requests a review of existing financial evidence.
  2. Eight edits remain: The claim remains held.
  3. Local failed eligibility records: These validation failures are not payer approval or evidence of a transport attempt.

4. Read the actual refusal

The panel reports CANONICAL-INVOICE-SCOPE-MISMATCH and says the invoice or claim identity, status or amounts differ from the committed visit. In this independently checked example the invoice is still Draft and has no issue date; the review requires an existing issued or balanced invoice with matching evidence. No eligible confirmation dialog opens. Keep the refusal and missing evidence visible; do not invent a rate, authority, approval or tax decision to dismiss it.

Read the actual draft-invoice review refusal. Genuine wide MANSOQ screen with fictional local training records.123
Recorded release 664f6a8f · 2026-10-19T02:59:23.623193+00:00 · 1728 × 921

Read the actual draft-invoice review refusal

Capture details

Exact committed 664f source, local isolated synthetic Clinic. Existing non-staff, non-superuser Clinic administrator. Source and 139 frontend assets were verified independently. This is local teaching, not production deployment, payer acceptance, legal authority or tax approval.

Image SHA-256 16de424e5697bcd36be69cd375ddf55997a96ff7cbcca536d135e55b26fa9053

  1. Scope or status refusal: The actual code is CANONICAL-INVOICE-SCOPE-MISMATCH. In this verified example the invoice is still Draft with no issue date.
  2. Review remains available: No eligible confirmation dialog is opened.
  3. View current claim evidence: Return to the pure claim evidence surface.

5. Return to current claim evidence

Select View current claim evidence. Confirm the same invoice link and draft tax pending outcome, and that the claim is still not submitted. A refused review does not establish a financial receipt or remove the independent coding, diagnosis, estimate and eligibility edits.

Read the actual draft-invoice review refusal. Genuine wide MANSOQ screen with fictional local training records.123
Recorded release 664f6a8f · 2026-10-19T02:59:23.623193+00:00 · 1728 × 921

Read the actual draft-invoice review refusal

Capture details

Exact committed 664f source, local isolated synthetic Clinic. Existing non-staff, non-superuser Clinic administrator. Source and 139 frontend assets were verified independently. This is local teaching, not production deployment, payer acceptance, legal authority or tax approval.

Image SHA-256 16de424e5697bcd36be69cd375ddf55997a96ff7cbcca536d135e55b26fa9053

  1. Scope or status refusal: The actual code is CANONICAL-INVOICE-SCOPE-MISMATCH. In this verified example the invoice is still Draft with no issue date.
  2. Review remains available: No eligible confirmation dialog is opened.
  3. View current claim evidence: Return to the pure claim evidence surface.
Verify the claim remains held after the refusal. Genuine wide MANSOQ screen with fictional local training records.123
Recorded release 664f6a8f · 2026-10-19T02:59:33.964947+00:00 · 1728 × 921

Verify the claim remains held after the refusal

Capture details

Exact committed 664f source, local isolated synthetic Clinic. Existing non-staff, non-superuser Clinic administrator. Source and 139 frontend assets were verified independently. This is local teaching, not production deployment, payer acceptance, legal authority or tax approval.

Image SHA-256 4e7c1abd754ca6750464164d8c4a79aa33151c0cc4ca3cf68b5d786bd02e97de

  1. Same invoice link: The saved claim still references the same invoice.
  2. Status remains held: The review refusal did not finalize the claim.
  3. Still not submitted: Review does not transmit a claim.

6. Inspect the invoice’s actual linked claim

Follow the Local Invoice link and read Claims behind this invoice. It now lists one initial draft_tax_pending claim. Read that saved linkage separately from payments and adjudication. The example still has no established tax determination or electronic invoice document.

Verify the claim remains held after the refusal. Genuine wide MANSOQ screen with fictional local training records.123
Recorded release 664f6a8f · 2026-10-19T02:59:33.964947+00:00 · 1728 × 921

Verify the claim remains held after the refusal

Capture details

Exact committed 664f source, local isolated synthetic Clinic. Existing non-staff, non-superuser Clinic administrator. Source and 139 frontend assets were verified independently. This is local teaching, not production deployment, payer acceptance, legal authority or tax approval.

Image SHA-256 4e7c1abd754ca6750464164d8c4a79aa33151c0cc4ca3cf68b5d786bd02e97de

  1. Same invoice link: The saved claim still references the same invoice.
  2. Status remains held: The review refusal did not finalize the claim.
  3. Still not submitted: Review does not transmit a claim.
Read one held claim behind the draft invoice. Genuine wide MANSOQ screen with fictional local training records.123
Recorded release 664f6a8f · 2026-10-19T02:59:52.579585+00:00 · 1728 × 921

Read one held claim behind the draft invoice

Capture details

Exact committed 664f source, local isolated synthetic Clinic. Existing non-staff, non-superuser Clinic administrator. Source and 139 frontend assets were verified independently. This is local teaching, not production deployment, payer acceptance, legal authority or tax approval.

Image SHA-256 9880e6f300d60b5c4421c45d47605d729132e0bf73794bd77ec946b58cab55f2

  1. One linked claim: The invoice now references one local initial claim.
  2. Held initial claim: The linked claim is draft_tax_pending.
  3. Local patient amount is not collectable approval: The screen’s adjudicated-share caption does not establish adjudication for this still-held draft.
Verify no electronic document was prepared. Genuine wide MANSOQ screen with fictional local training records.12
Recorded release 664f6a8f · 2026-10-19T02:58:08.249055+00:00 · 1728 × 921

Verify no electronic document was prepared

Capture details

Exact committed 664f source, local isolated synthetic Clinic. Existing non-staff, non-superuser Clinic administrator. Source and 139 frontend assets were verified independently. This is local teaching, not production deployment, payer acceptance, legal authority or tax approval.

Image SHA-256 8f2866742b35e5326438e7846045cc8f483a12929386bfc2f9d9e4a453925088

  1. No electronic document: The draft has no prepared electronic invoice document.
  2. Recorded draft author: The existing synthetic administrator created this draft.

Local validation records are different from transport

The case screen shows three failed eligibility entries in this recorded example. Two existed before this draft; one additional local validation record was created automatically when normal account rebalancing saved the account. Source and independent record checks show validation_failed with an empty endpoint, no sent/received timestamp and zero transport attempts. These entries are not payer replies or a successful NPHIES submission.

Locate Review on the selected held case. Genuine wide MANSOQ screen with fictional local training records.123
Recorded release 664f6a8f · 2026-10-19T02:59:13.295143+00:00 · 1728 × 921

Locate Review on the selected held case

Capture details

Exact committed 664f source, local isolated synthetic Clinic. Existing non-staff, non-superuser Clinic administrator. Source and 139 frontend assets were verified independently. This is local teaching, not production deployment, payer acceptance, legal authority or tax approval.

Image SHA-256 6a0444ec76727f5df12eabc65e8df36ac75eadbcd73340fa71e00708964d94c8

  1. Review existing invoice tax: This requests a review of existing financial evidence.
  2. Eight edits remain: The claim remains held.
  3. Local failed eligibility records: These validation failures are not payer approval or evidence of a transport attempt.
Read the actual draft-invoice review refusal. Genuine wide MANSOQ screen with fictional local training records.123
Recorded release 664f6a8f · 2026-10-19T02:59:23.623193+00:00 · 1728 × 921

Read the actual draft-invoice review refusal

Capture details

Exact committed 664f source, local isolated synthetic Clinic. Existing non-staff, non-superuser Clinic administrator. Source and 139 frontend assets were verified independently. This is local teaching, not production deployment, payer acceptance, legal authority or tax approval.

Image SHA-256 16de424e5697bcd36be69cd375ddf55997a96ff7cbcca536d135e55b26fa9053

  1. Scope or status refusal: The actual code is CANONICAL-INVOICE-SCOPE-MISMATCH. In this verified example the invoice is still Draft with no issue date.
  2. Review remains available: No eligible confirmation dialog is opened.
  3. View current claim evidence: Return to the pure claim evidence surface.

Read the patient-share caption cautiously for this held draft

The invoice panel calls SAR 30 an Adjudicated share, but this example’s claim is still draft_tax_pending and its adjudication is unknown. The amount comes from the local committed claim snapshot; the caption does not establish an adjudication or a collectable patient balance. Keep those meanings separate.

Read the new invoice-linked held claim. Genuine wide MANSOQ screen with fictional local training records.123
Recorded release 664f6a8f · 2026-10-19T02:58:47.992741+00:00 · 1728 × 921

Read the new invoice-linked held claim

Capture details

Exact committed 664f source, local isolated synthetic Clinic. Existing non-staff, non-superuser Clinic administrator. Source and 139 frontend assets were verified independently. This is local teaching, not production deployment, payer acceptance, legal authority or tax approval.

Image SHA-256 4e7c1abd754ca6750464164d8c4a79aa33151c0cc4ca3cf68b5d786bd02e97de

  1. Actual invoice link: The new local claim references the saved draft invoice.
  2. Draft tax pending: The claim remains held, not externally accepted.
  3. Not submitted: No payer submission is represented.
Read one held claim behind the draft invoice. Genuine wide MANSOQ screen with fictional local training records.123
Recorded release 664f6a8f · 2026-10-19T02:59:52.579585+00:00 · 1728 × 921

Read one held claim behind the draft invoice

Capture details

Exact committed 664f source, local isolated synthetic Clinic. Existing non-staff, non-superuser Clinic administrator. Source and 139 frontend assets were verified independently. This is local teaching, not production deployment, payer acceptance, legal authority or tax approval.

Image SHA-256 9880e6f300d60b5c4421c45d47605d729132e0bf73794bd77ec946b58cab55f2

  1. One linked claim: The invoice now references one local initial claim.
  2. Held initial claim: The linked claim is draft_tax_pending.
  3. Local patient amount is not collectable approval: The screen’s adjudicated-share caption does not establish adjudication for this still-held draft.

Source evidence

Every citation uses this exact committed version. The private source repository requires access.