Estimate Review Queue
The Estimate Review Queue is a module that places all designated assignments returned from your adjusters into a list for a desk review. The administrator assigns specific estimates to individual reviewers for approval. If the queue is turned on, you can see the current status of the assignment on the Assignment Detail page, for example Estimate Not Reviewed.
In the Estimate Review Queue, the insurer and service provider can perform reviews on the same estimate simultaneously without affecting each other’s reviews. The insurer and the service provider can also configure rules, set statuses, run advanced search filters, and create personal rules for their own review processes in the Estimate Review Queue.
The screen shots in this document are generic, and your company’s interface may vary.
Manually add assignments to the queue
Search for estimates by review status
Administrator and Reviewer Roles
User 1: Administrator
Add Queue Rule fields and menus
Related: Estimate Review Queue Statuses, FAQ > Assignment Questions, Advanced Search
Access Estimate Review Queue
Select Estimate Review Queue or My Estimate Review Queue from the Assignments menu. If you select My Estimate Review Queue, you will see only estimates assigned to you.
- You must have the Estimate Reviewer or Estimate Reviewer Administrator application right to access the Estimate Review Queue. See User Administration for information about adding rights.
Users with Reviewer rights will only see estimates assigned to them. Users with Estimate Review Administrator rights will see all estimates, regardless of the assigned reviewer.
Note that the Estimate Review Queue has columns that show the insurer review status and service provider review status on assignments with multiple reviewers. Both statuses show for an insurer user and for a service provider user. For more information about adding or removing columns see Column Admin or User Column Admin.
Filter Estimate Review Queue
You can filter the Estimate Review Queue to view only assignments from specified criteria - such as from a specific insurer, recipient, reviewer, assignment status, or date. You can also save and name your filter selections for future use.
Apply quick filters
The Filters Used section provides a few quick filters for convenience. You can select a previously saved filter set, sort the list by an assignment status date, and select a date range. Click Search to apply your selections.
To reset the filters in this section to their default settings, click Reset.
- If No Date Filter is selected in the date filter menu, the selected Start Date and End Date do not apply to the filter.
Apply advanced filters
To apply detailed filters to the queue, click Queue Filter in the Filters Used section. The Estimate Review Queue Filter dialog ue box appears.
Select your criteria from the filter menus and click Search. The Estimate Review Queue updates to only display estimates that fit your selected parameters.
To reset the filters to their default settings, click Reset at the bottom of the dialogue box.
Save filter selections
After you click Queue Filter and select a group of filter options from the Estimate Review Queue Filter dialog ue box, you can save and name that group for future use.
To save your filter selections, click Save Filter As, enter a name in the Save Search Name box, and click Confirm.
To delete saved filter selections, select its name from the Saved Filters menu and click Remove Filter.
To rename a filter selection, select its name from the Saved Filters menu, click Rename Filter, enter a name in the Save Search Name box, and click Confirm.
To modify your filter selection, change the criteria you want and click Save Filter.
Manually add assignments to the queue
If you have a specific assignment that you want to add to the queue, manually adding it is often quicker than creating a rule.
Under Search Results, select Add Claim # to Queue from the Select an Action menu.
Enter the claim number in the Claim # to Add text box that appears.
Click Go. The assignment is added to the queue.
Search for estimates by review status
You can search for estimates by review queue status in Advanced Search. In the Filter Criteria section, click the Review Status menu and select an option to filter your search.
- The options available in this menu may differ depending on your company and user type.
Administrator and Reviewer Roles
Administrators and reviewers use the Estimate Review Queue in different ways. Their workflows are explained in this section.
User 1: Administrator
Set up review queue rules
As an administrator, you can set up Estimate Review Queue Rules to look for specific criteria in each returned estimate to determine which estimates will go into the queue to be reviewed. You can even configure rules to automatically assign specific reviewers to estimates. Only users with the Estimate Review Administrator rights can access the review queue rules.
Click Estimate Review Queue Rules.
- If Estimate Review Queue Rules is not available in your version of XactAnalysis, all uploaded claims will appear in your Review Queue by default. Contact your product specialist or account manager for information about the Review Queue Rules feature.
Click Add New Rule. The Add Queue Rule dialog ue box appears.
Select the criteria for your rule and click OK. For more information about the fields and menus in this dialogue box, see Add Queue Rule fields and menus.
- Any rule you set can affect which claims appear in your Review Queue.
In the Estimate Review Queue Rules page you can also do the following:
View all rules or only rules you created using the rule filters.
Copy or delete rules by clicking Copy or Delete to the right of a rule.
Export rules to an Excel worksheet by clicking Export All To Excel.
Assign reviewer
When assigning a reviewer in the Estimate Review Queue, only the reviewers (users) in your account will show up in XactAnalysis. Service provider users do not see insurer users, and vice versa. By default, assigned reviewers have to accept the review, as a separate step, before completing it. Please speak to your product specialist or account manager if you would like to turn this feature off. This would allow a reviewer to complete a review without first accepting it.
In the Estimate Review Queue, select the check box for each estimate you would like to assign to a reviewer.
Select Assign from the Select an Action menu.
Select a reviewer from the menu that appears.
Click Go.
The Assign Reviewer dialogue box appears. Verify the reviewer name and click Assign Reviewer. If the reviewer name is incorrect, click Cancel.
- You can re-assign an estimate to a different reviewer by repeating this process and selecting Reassign from the Select an Action menu.
Set Reviewer Rotation
Set Reviewer Rotation allows you to select a group of reviewers and automatically assign them on a rotational basis to assignments added by queue rules.
- To use this feature, it must be activated by your account manager and you must have the ERQ Reviewer Rotation application right.
Click Set Reviewer Rotation.
Select the check boxes for the reviewers you want in the rotation. The rotation order is alphabetical by user name. After a reviewer is selected, they are then placed at the bottom of the rotation.
Click Save.
Decide which of your queue rules will trigger the reviewer rotation. The Use Reviewer Rotation for This Rule check box in the Add Queue Rule dialogue box must be selected for each of these rules. You can select it when you add a new rule, or you can create a copy of an existing rule, select the check box, and delete the old rule.
User 2: Reviewer
As a Reviewer, you may view estimate details, approve or reject items, notify others, and mark reviews complete.
Accept estimate review
Select Estimate Review Queue or My Estimate Review Queue in the Assignments menu, and you will see a list of estimates that have been assigned to you.
Select the estimate you want to review. The Assignment Detail page appears.
There are two ways to accept an estimate review. You may click Accept Review in the Workflow Status section of the Details tab, or you may select Accept Estimate Review from the Select an Action menu, and click Go.
The Update Status to Review Accepted dialogue box appears. From here you can write a note regarding the acceptance of the review and send an update status notification to others by email or XactNet address.
Click Update Status.
Review estimate
To review an estimate, you can look over reports in the Documents tab, photos in the Photos tab, and sketches in the Sketches tab. After reviewing the item(s) in a particular tab, select the check boxes for the items you would like to approve or reject; then click Approve Item(s) or Reject Item(s).
- If document control is enabled, you will need to approve all documents under these tabs to allow your client (the insurer) to access them. If the documents have not been approved by your company, your client will be unable to view them.
After you have reviewed the estimate, select Complete Review in the Workflow Status section of the Details tab.
The Update Status to Reviewed dialogue box appears. Mark the review as complete (select Estimate Reviewed), or indicate that you have some reservations about the review process (select Estimate Reviewed with Exceptions) at which time you can notify the assignee, along with others, by sending an email.
Click Update Status to complete the review.
The status in the Assignment Detail header changes to Estimate Review Complete.
The insurer’s review status and the service provider’s review status updates to Reviewed in the Workflow Status area. The insurer and the service provider can see the date and time stamp when each review was completed.
Add Queue Rule fields and menus
Data Set(s)
Select one or more data sets to allow estimates from those data sets to enter the queue.
- If you select more than one data set, some filters may become unavailable due to the unique filter settings of each selected data set.
Rule Name / Description
Enter the name or description of your rule.
Rule Priority
Select a priority for your rule: None, 1 (First Group Processed), or 2 (Second Group Processed). The rules filter estimates based on priority. XactAnalysis will filter all the estimates with the first priority rule, and then filter the remaining estimates with the second priority rule.
Use Reviewer Rotation for This Rule
Select this check box to use the reviewer rotation for this rule.
ALL REQUIRED (All of the selected conditions must be met to send an assignment to the review queue.)
Apply this rule to
Select to apply the rule to future or existing estimates
With a XactAnalysis status of
Select a status or leave it as (All). See Statuses for status definitions. If you select Cancell ed or Client Approved, you can also filter by how that status is set (Automatically, Manually, or Either).
Hierarchy Type
Select a hierarchy type: Geographic, Organizational, or Individual.
Area
Select an area for the rule. Leave it as (All) to allow assignments from all data set (program) areas into the review queue.
Desk Adjuster
Select a desk adjuster. Leave this field blank to allow estimates with any desk adjuster into the queue.
For this CAT Code
Enter a CAT Code into the auto-complete field and select from the list. To enter more than one CAT Code, separate them by commas. Leave this field blank to allow estimates with any CAT code into the review queue.
For this Claim Reference
Enter a claim reference. Leave this field blank to allow any claim reference into the review queue.
For these Countries/Regions
Select one or more countries/regions from the menu. Leave this field blank to allow estimates from any country/region to enter the queue.
For this Policy Type
Select a policy type from the menu. Select (All) to allow estimates with any policy type to enter the queue.
For this Coverage Type
Select a coverage type from the menu. Select (All) to allow estimates with any coverage type to enter the queue.
For this Business Unit
Select a business unit from the menu. Select (All) to allow estimates with any business unit into the review queue.
For this Peril
Select one or more perils from the menu. Select (All) to allow estimates with any peril into the review queue.
For this Postal Code
Enter one or more postal codes (separated by commas). Leave this field blank to allow all estimates from all postal codes into the review queue.
For date range between
Select a date range or select Monthly, Quarterly, or Annually from the menu. The rule will be applied to estimates within the specified range only or it will be applied monthly, quarterly, or annually. Leave these fields blank if you do not wish to apply a date range to the rule.
1 of every (randomly)
Enter a number to set up random reviews for one of every [number] estimates.
Percentage to add to queue
Enter a percentage of claims to randomly be added to the queue.
Number of estimates
Enter a number of estimates to send to the review queue. Select the per adjuster/contractor check box, to send a specific number of estimates based on the number of adjusters and contractors you have set up to review assignments.
For estimate value between
Enter a value range.
Estimate Correction Percent
Enter a percentage that the estimate correction must exceed to enter the review queue.
Compared to referral estimate
Select this check box to create a rule that catches referral estimates with values that differ from their original estimate values by the percent or value amount entered in the fields above the check box.
Correction Value
Enter an amount the estimate correction must exceed to enter the review queue.
Job Type
Select a job type.
Overhead & Profit
Select whether to include estimates with O&P or No O&P. Select No Selection for neither.
Estimate Contains
Select whether or not to include O&P as part of your rule.
Number of trades are
Select whether or not to include estimates greater than or less than a certain number of trades, or select No Selection for neither. Enter the greater than or less than number in the provided field.
Selected trades
Click the SmartList icon in this field to select which trades are included in this rule.
Contains pricelist category
Select a pricelist category from the menu.
Activity Diary Report Uploads
Select the check box to exclude activity diary report uploads.
Third Party Collaborations
Select the check box to exclude third-party collaborations.
Test Assignments
Select the check box to include test assignments. Leave unchecked to exclude test assignments.
ONE REQUIRED (This section appears when you select Apply this rule to only future estimates in the All Required section.)
Audit Results
Select Any to send estimates with any audit results into the review queue. Select Specific and one or more audit results from the list that appears.
- When you select any of the Audit Violation check boxes, the Audit action for each item in the Contains Line Item feature (in the Line Items section) is disabled.
Audit Violation Count
Enter a number. All estimates with that number of violations are sent to the review queue. Select the Greater than check box to send estimates with violations totaling more than the entered number to the review queue.
Category - Selector Codes within Estimate Include
Select the check boxes to include estimates with specific selector codes in the review queue.
Line Item Quality
Select the check boxes to include estimates with specific line item qualities in the review queue.
Price List
Select the Deviations check box to send estimates with price list deviations into the review queue. For Price Only Deviations, you can choose to identify estimates by the number of items with deviations or by the deviation amount.
Pricing Variations
Select the check box to send estimates with pricing variations into the review queue.
Item Rate Association
Select the check box to select if the rule is triggered on the Household or Contractor rate.
LINE ITEMS
This section allows you to create queue rules based on the line items included in estimates.
Use the All Required feature to identify estimates with all the line items you enter here.
Use the One Required feature to identify estimates with at least one of the line items you enter here.
You do not need to enter information into each menu and box. For example, you could use only the Category menu, sending estimates to the queue that have line items from a specific category.
Select a Country.
Select the Category for the line item. The Activity box will automatically be filled in.
Choose a Selector.
Choose whether the rule will look for a line item with a specific amount (equal to the number you enter) or a line item with more or less than a specific amount.
Choose whether the rule will look for items at the line item level or the estimate level. Line item rules will look for a single line item that matches the criteria. Estimate level rules will look for a total of line items that match the criteria.
Select whether the rule will look for corrected line items, not corrected, or neither.
To add more line item identifiers, click Add. To remove an identifier, click Delete.
GTA ITEMS
This section allows you to create queue rules based on an estimate's grand total adjustment percentage or value. The rule is triggered when one or both criteria are met.
Percent
Enter a percentage of the estimate subtotal. The rule is triggered if the estimate's grand total adjustment is greater than this percentage of the estimate subtotal.
Value
Enter a monetary value. The rule is triggered if the estimate's grand total adjustment is greater than this value.
OTHER
Notification Language Setting
Select a language in which to receive the notification. Languages include English (United States, English (Canada), French (Canada), German (Germany), and Spanish (Spain).
Client Approval
Select Manual to allow client reviewers to manually review and approve the estimates in the queue. Select Auto Approve to automatically approve the estimates in the queue based on the criteria of the rule.
Email To
Enter one or more email addresses (separated by commas). XactAnalysis sends an email to the specified addresses when an estimate triggers this rule and is sent to the Estimate Review Queue.
Automatically assign to
Enter the name of a reviewer to be specifically assigned or select (All). Estimates sent to the queue by this rule can be automatically assigned a reviewer that you specify here.
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