Claim flows and transaction status

Once successfully submitted, a claim will be categorised into one of the following transaction statuses:

Transaction status	Description
Outstanding	QBE has responded with Pending Review. The Tyro Health transaction will be in this state until QBE has reviewed it and responded later with Accepted or Rejected.
Approved	One or more claim items accepted and approved by QBE. Settlement not yet issued to provider.
Completed	An Approved claim where payment has been issued by Tyro Heath to the provider.
Declined	QBE has responded with Rejected. Tyro Health will not payout the claim
Cancelled	Tyro health have initiated a cancellation request on the claim and QBE have responded with a successful cancellation

Some claims will be processed instantly by QBE using their straight-through adjudication method. Those claims will return an approved or declined status within 30 seconds and the SDK will return that status via a callback.

However, partners will need to accommodate claims which undergo manual review and status updates hours to days post submission. For each claim, a partner can nominate one or more webhooks which fire depending on the status . Each successfully submitted claim will also return, via SDK callback, a Tyro Health unique transaction Id which can be used to periodically poll for current status.

Note: all new partners should refer to transaction.businessStatus only as transaction.status is obsolete.