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The following requirements were considered when updating openIMIS’s Claim adjudication process:

  • the default openIMIS Claim adjudication process should be modified as less as possible

  • Medical Officers should not be impacted too much by the activation of the openIMIS-AI module

The following state diagram from Figure 1 corresponds to the Claim fields status with the updated adjudication process.

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Figure 1. Claim state diagram for the updated claim adjudication process