Rules
Every rule this client runs, grouped by the moment it fires. A rule is when this, then that, and it can be switched off without being deleted.
Who Can See It
Section titled “Who Can See It”Administrator, when the client is licensed for rules. Only an Administrator has Rules in the sidebar, and only an Administrator can create, change, select or delete rules.
A User who opens the screen from a link sees the library read-only: the trigger tabs and the rules in them, with no New rule, no selection and no bulk bar.
The Library
Section titled “The Library”Rules are grouped by trigger, one tab each with its icon and count, with totals for how many rules exist and how many are active above. The open tab’s “Fires when” sentence sits on its own line under the tab row.
| Trigger | When it fires |
|---|---|
| Claim Review | A claim is scrubbed: at generation, on every pre-billing edit, and on demand |
| Coding Review | Charges from a feed sent to Coding Review are checked: after the import, whenever the visit’s readiness is evaluated, and on Release to Billing |
| Patient Imported | A patient arrives from an import |
| Remittance Imported | A remittance arrives from a payer |
| Statement Generated | A patient statement is checked: at generation, and whenever its bill-to is repaired |
| Visit Ready | A visit is checked for readiness |
| Column | What it shows |
|---|---|
| Name | The rule, with a chip for a library rule: Library, Modified, Update Available or Retired |
| Conditions | The rule’s conditions, as chips |
| Outcomes | What it does when it fires, as chips toned by severity |
| Last seen | When the rule last raised a finding |
| Active | Active or Inactive |
Search matches a rule’s name and its condition and outcome labels.
Actions
Section titled “Actions”| Action | What it does | When it is offered |
|---|---|---|
| New rule | Opens the workspace on a blank rule | Administrator only |
| Add Filter | Narrows the library by Status: Active or Inactive | Always |
| Open | Opens the rule in its workspace | Row menu, or select the row |
| Duplicate | Copies the rule. The copy starts inactive | Row menu, Administrator only |
| View History | Opens Rule History: who changed the rule and what they changed | Row menu |
| Delete | Deletes that rule | Row menu, Administrator only |
| Activate | Switches the selected rules on | Once rules in the tab are selected |
| Deactivate | Switches the selected rules off | Once rules in the tab are selected |
| Delete… | Asks to confirm, then deletes the selected rules. They stop firing immediately; their past runs stay in the audit log | Once rules in the tab are selected |
| Apply All | Applies every waiting library update to the rules you have not modified, after a confirmation | When the banner reports library updates ready to apply |
Selecting rows opens a bar at the bottom of the screen with Activate and Deactivate, and Delete… under More. The checkbox in the header selects every rule in the tab. A bulk action runs as a tracked run: a panel reports each rule’s result, and the run stays under Update Batches. A rule whose definition no longer validates fails Activate with the reason, and you fix it in its workspace. Switching tabs clears the selection. On Claim Review rules a bulk action also re-checks open claims, and the run’s result says, for example, “Re-checking 42 claims.”.
Apply All skips modified rules; the banner counts them, and you review each one in its workspace. Opening a rule opens The Rule Workspace.
When a Change Takes Effect
Section titled “When a Change Takes Effect”For most triggers a rule change applies from the next evaluation. A Claim Review change re-checks open claims at once: creating an active rule, a save that changes what it decides, deleting an active rule, applying a library update, and a bulk Activate, Deactivate or Delete… all start a re-check of every Draft and Ready claim, which you can follow under Update Batches. The re-check only judges: a Ready claim with a blocking finding goes back to Draft, a Draft claim’s findings refresh, nothing moves forward, and a Ready claim held by an export batch is skipped. Sent claims are never re-judged; How Rules Work explains why.
States
Section titled “States”- Empty - a tab with no rules says “No Claim Review rules yet”, and for an Administrator adds that New rule starts the first one.
- No rules match the search, quoting what you typed.
- With Status set to Active and no active rules, the library says “No active rules” and how many inactive ones clearing the filter shows.
- We couldn’t load rules. with a retry when the library cannot be fetched.
- No client selected - Rules stays out of the sidebar until you pick a client, because every rule belongs to one.
- Blocked - without the rules module the screen is not in the sidebar, and a saved link to it says the module is not part of your plan.
Related: The Rule Workspace · How Rules Work