Below are the steps to be followed for performing the claim retagging process. This process is to switch the claims from one source to another.
Make sure the below criteria is met.
1) There is a record available for the claim in Tagclaimmaster table with that vendor and ProjectID (from which the claim needs to be retagged). Make a note of the Current status of the claim.
2) There is a letter record (Overpayment) available in LET_Letter table with that vendor and ProjectID (from which the claim needs to be retagged) with ReferenceSourceName as 'CIMS'. If there is an Appeal then an appeal letter should also be available with ReferenceSourceName as 'Appeal'
3) Make sure respective project is mapped to the vendor to which the claim needs to be retagged with the Query below.
(Here the example is for the Source Molina & Project MOL-ME-RETRO_DISENROLL_MC_PRMRY )
Select * from VendorConceptDetails where VendorID=1 and projectID like '%MOL-ME-RETRO_DISENROLL_MC_PRMRY%'
Also make sure there is a concept rule available for the vendor for that particular project with the below query.
Select * from Rul_Rulemaster where Project like '%MOL-ME-RETRO_DISENROLL_MC_PRMRY%' and EntityID=1 and RulecategoryID=3
After making sure the above criteria, execute the below update statements for updating VendorID and ProjectID in both Tagclaimmaster and LET_Letter tables for the respective ClaimID and tagclaimmasterID.
Update statement
UPDATE TagClaimMaster
SET EntityID=1
,ProjectID='MOL-ME-RETRO_DISENROLL_MC_PRMRY'
,EXTPROJREFID = NULL
WHERE ClaimID = 317738805 and TagClaimMasterID IN (2566950
)
GO
UPDATE LET_Letter
SET EntityID=1
,ProjectID='MOL-ME-RETRO_DISENROLL_MC_PRMRY'
WHERE ClaimID = 317738805
AND letterID in (2019603,2156632)