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