Mopane Medical Scheme: one claim from provider portal to member app

Mopane Medical Scheme: one claim from provider portal to member app A sequence diagram generated by Archify. submit claim lodge claim (ref C-2291) Claim reference is theidempotency key accepted for assessment receipt check cover and benefit Observed at a pinnedcommit active, R1,240 available Engine applies schemerules. Amount illustrative claim decided event Assumed: ownerconfirmation outstanding claim paid notification remittance advice Intake Adjudication Outcome Provider · practice system · Sequence participant Provider practice system Provider Portal · claim intake · Sequence participant Provider Portal claim intake Claims Engine · adjudication · Sequence participant Claims Engine adjudication Member Registry · cover and benefits · Sequence participant Member Registry cover and benefits Data Warehouse · claims history · Sequence participant Data Warehouse claims history Member App · notifications · Sequence participant Member App notifications Legend main request return security async trace message