Problem
Use the BPMN method (following the BPMN notation) to design the process map for the process
Insurance Claims Processing
A. Claimants can submit insurance claims either on-line or use a paper claim form
B. When a paper claim form is received, it's scanned into images
C. A claim case will be created in the claims database from an online submission, or from images
D. A Claim Examiner will review claims to see if the claim is complete (meaning no missing information)
E. If a claim is incomplete, the Claim Examiner will request missing information from the claimant. The Claim Examiner will decline the claim if the requested document is not received within 60 days.
F. If a claim is complete or the missing information is received, the Claim Examiner will adjudicate the claim.
G. The claim is either approved or declined.
H. If the claim is approved, send a payment check to the claimant
I. If the claim is declined, send a denial letter to the claimant.