Estimate Review Queue

The Estimate Review Queue is a module that places all designated assignments returned from your adjusters into a list for a desk review. The administrator assigns specific estimates to individual reviewers for approval. If the queue is turned on, you can see the current status of the assignment on the Assignment Detail page, for example Estimate Not Reviewed.

In the Estimate Review Queue, the carrier and service provider can perform reviews on the same estimate simultaneously without affecting each other’s reviews. The carrier and the service provider can also configure rules, set statuses, run advanced search filters, and create personal rules for their own review processes in the Estimate Review Queue.

The screen shots in this document are generic, and your company’s interface may vary.

Access Estimate Review Queue

Select Estimate Review Queue or My Estimate Review Queue from the Assignments menu. If you select My Estimate Review Queue, you will see only estimates assigned to you.

Users with Reviewer rights will only see estimates assigned to them. Users with Estimate Review Administrator rights will see all estimates, regardless of the assigned reviewer.

Note that the Estimate Review Queue has columns that show the carrier review status and service provider review status on assignments with multiple reviewers. Both statuses show for a carrier user and for a service provider user. For more information about adding or removing columns see Column Admin or User Column Admin.

Filter Estimate Review Queue

You can filter the Estimate Review Queue to view only assignments from specified criteria - such as from a specific insurer, recipient, reviewer, assignment status, or date. You can also save and name your filter selections for future use.  

Apply quick filters

The Filters Used section provides a few quick filters for convenience. You can select a previously saved filter set, sort the list by an assignment status date, and select a date range. Click Search to apply your selections.

• To reset the filters in this section to their default settings, click Reset.

Apply advanced filters

To apply detailed filters to the queue, click Queue Filter in the Filters Used section. The Estimate Review Queue Filter dialog box appears.

• Select your criteria from the filter menus and click Search. The Estimate Review Queue updates to only display estimates that fit your selected parameters.
• To reset the filters to their default settings, click Reset at the bottom of the dialog box.

Save filter selections

After you click Queue Filter and select a group of filter options from the Estimate Review Queue Filter dialog box, you can save and name that group for future use.

• To save your filter selections, click Save Filter As, enter a name in the Save Search Name box, and click Confirm.
• To delete saved filter selections, select its name from the Saved Filters menu and click Remove Filter.
• To rename a filter selection, select its name from the Saved Filters menu, click Rename Filter, enter a name in the Save Search Name box, and click Confirm.
• To modify your filter selection, change the criteria you want and click Save Filter.

Manually add assignments to the queue

If you have a specific assignment that you want to add to the queue, manually adding it is often quicker than creating a rule.

1. Under Search Results, select Add Claim # to Queue from the Select an Action menu.
2. Enter the claim number in the Claim # to Add text box that appears.
3. Click Go. The assignment is added to the queue.

Search for estimates by review status

You can search for estimates by review queue status in Advanced Search. In the Filter Criteria section, click the Review Status menu and select an option to filter your search.

Administrator and Reviewer Roles

Administrators and reviewers use the Estimate Review Queue in different ways. Their workflows are explained in this section.

User 1: Administrator

Set up review queue rules

As an administrator, you can set up Estimate Review Queue Rules to look for specific criteria in each returned estimate to determine which estimates will go into the queue to be reviewed. You can even configure rules to automatically assign specific reviewers to estimates. Only users with the Estimate Review Administrator rights can access the review queue rules.

1. Click Estimate Review Queue Rules.

1. Click Add New Rule. The Add Queue Rule dialog box appears.
2. Select the criteria for your rule and click OK. For more information about the fields and menus in this dialog box, see Add Queue Rule fields and menus.

In the Estimate Review Queue Rules page you can also do the following:

• View all rules or only rules you created using the rule filters.
• Copy or delete rules by clicking Copy or Delete to the right of a rule.
• Export rules to an Excel worksheet by clicking Export All To Excel.

Assign reviewer

When assigning a reviewer in the Estimate Review Queue, only the reviewers (users) in your account will show up in XactAnalysis. Service provider users do not see carrier users, and vice versa. By default, assigned reviewers have to accept the review, as a separate step, before completing it. Please speak to your product specialist or account manager if you would like to turn this feature off. This would allow a reviewer to complete a review without first accepting it.

1. In the Estimate Review Queue, select the check box for each estimate you would like to assign to a reviewer.
2. Select Assign from the Select an Action menu.

1. Select a reviewer from the menu that appears.
2. Click Go.
3. The Assign Reviewer dialog box appears. Verify the reviewer name and click Assign Reviewer. If the reviewer name is incorrect, click Cancel.

Set Reviewer Rotation

Set Reviewer Rotation allows you to select a group of reviewers and automatically assign them on a rotational basis to assignments added by queue rules.

Click Set Reviewer Rotation.

Select the check boxes for the reviewers you want in the rotation. The rotation order is alphabetical by user name. After a reviewer is selected, they are then placed at the bottom of the rotation.

Click Save.

Decide which of your queue rules will trigger the reviewer rotation. The Use Reviewer Rotation for This Rule check box in the Add Queue Rule dialog box must be selected for each of these rules. You can select it when you add a new rule, or you can create a copy of an existing rule, select the check box, and delete the old rule.

User 2: Reviewer

As a Reviewer, you may view estimate details, approve or reject items, notify others, and mark reviews complete.

Accept estimate review

1. Select Estimate Review Queue or My Estimate Review Queue in the Assignments menu, and you will see a list of estimates that have been assigned to you.
2. Select the estimate you want to review. The Assignment Detail page appears.
3. There are two ways to accept an estimate review. You may click Accept Review in the Workflow Status section of the Details tab, or you may select Accept Estimate Review from the Select an Action menu, and click Go.

The Update Status to Review Accepted dialog box appears. From here you can write a note regarding the acceptance of the review and send an update status notification to others by email or XactNet address.

1. Click Update Status.

Review estimate

1. To review an estimate, you can look over reports in the Documents tab, photos in the Photos tab, and sketches in the Sketches tab. After reviewing the item(s) in a particular tab, select the check boxes for the items you would like to approve or reject; then click Approve Item(s) or Reject Item(s).

1. After you have reviewed the estimate, select Complete Review in the Workflow Status section of the Details tab.
2. The Update Status to Reviewed dialog box appears. Mark the review as complete (select Estimate Reviewed), or indicate that you have some reservations about the review process (select Estimate Reviewed with Exceptions) at which time you can notify the assignee, along with others, by sending an email.
3. Click Update Status to complete the review.

The status in the Assignment Detail header changes to Estimate Review Complete.

The carrier’s review status and the service provider’s review status updates to Reviewed in the Workflow Status area. The carrier and the service provider can see the date and time stamp when each review was completed.

Add Queue Rule fields and menus

Data Set(s)

Select one or more data sets to allow estimates from those data sets to enter the queue.

Rule Name / Description

Enter the name or description of your rule.

Rule Priority

Select a priority for your rule: None, 1 (First Group Processed), or 2 (Second Group Processed). The rules filter estimates based on priority. XactAnalysis will filter all the estimates with the first priority rule, and then filter the remaining estimates with the second priority rule.

Use Reviewer Rotation for This Rule

Select this check box to use the reviewer rotation for this rule.

ALL REQUIRED (All of the selected conditions must be met to send an assignment to the review queue.)

Apply this rule to

Select to apply the rule to future or existing estimates

With a XactAnalysis status of

Select a status or leave it as (All). See Statuses for status definitions. If you select Canceled or Client Approved, you can also filter by how that status is set (Automatically, Manually, or Either).

Hierarchy Type

Select a hierarchy type: Geographic, Organizational, or Individual.

Area

Select an area for the rule. Leave it as (All) to allow assignments from all data set (program) areas into the review queue.

Desk Adjuster

Select a desk adjuster. Leave this field blank to allow estimates with any desk adjuster into the queue.

For this CAT Code

Enter a CAT Code into the auto-complete field and select from the list. To enter more than one CAT Code, separate them by commas. Leave this field blank to allow estimates with any CAT code into the review queue.

For this Claim #

Enter a claim number. Leave this field blank to allow any claim number into the review queue.

For this State(s)

Select one or more states from the menu. Leave this field blank to allow estimates from any state to enter the queue.

For this Policy Type

Select a policy type from the menu. Select (All) to allow estimates with any policy type to enter the queue.

For this Coverage Type

Select a coverage type from the menu. Select (All) to allow estimates with any coverage type to enter the queue.

For this Business Unit

Select a business unit from the menu. Select (All) to allow estimates with any business unit into the review queue.

For this Type of Loss

Select one or more types of loss from the menu. Select (All) to allow estimates with any type of loss into the review queue.

For this Postal Code

Enter one or more postal codes (separated by commas). Leave this field blank to allow all estimates from all postal codes into the review queue.

For date range between

Select a date range or select Monthly, Quarterly, or Annually from the menu.  The rule will be applied to estimates within the specified range only or it will be applied monthly, quarterly, or annually. Leave these fields blank if you do not wish to apply a date range to the rule.

1 of every (randomly)

Enter a number to set up random reviews for one of every [number] estimates.

Percentage to add to queue

Enter a percentage of claims to randomly be added to the queue.

Number of estimates

Enter a number of estimates to send to the review queue. Select the per adjuster/contractor check box, to send a specific number of estimates based on the number of adjusters and contractors you have set up to review assignments.

For estimate value between

Enter a value range.

Estimate Correction Percent

Enter a percentage that the estimate correction must exceed to enter the review queue.

Compared to referral estimate

Select this check box to create a rule that catches referral estimates with values that differ from their original estimate values by the percent or value amount entered in the fields above the check box.

Correction Value

Enter an amount the estimate correction must exceed to enter the review queue.

Job Type

Select a job type.

Overhead & Profit

Select whether to include estimates with O&P or No O&P. Select No Selection for neither.

Estimate Contains

Select whether or not to include O&P as part of your rule.

Number of trades are

Select whether or not to include estimates greater than or less than a certain number of trades, or select No Selection for neither. Enter the greater than or less than number in the provided field.

Selected trades

Click the SmartList icon in this field to select which trades are included in this rule.

Contains pricelist category

Select a pricelist category from the menu. 

Activity Diary Report Uploads

Select the check box to exclude activity diary report uploads.

Third Party Collaborations

Select the check box to exclude third-party collaborations.

Test Assignments

Select the check box to include test assignments. Leave unchecked to exclude test assignments.

ONE REQUIRED 

(This section appears when you select Apply this rule to only future estimates in the All Required section.)

Audit Results

Select Any to send estimates with any audit results into the review queue. Select Corrected to send estimates in which audit violations have been corrected into the queue. Select Not Corrected to send estimates in which audit violations were not corrected into the queue. Select Specific and one or more audit results from the list that appears.

Audit Violation Count

Enter a number. All estimates with that number of violations are sent to the review queue. Select the Greater than check box to send estimates with violations totaling more than the entered number to the review queue.

Category - Selector Codes within Estimate Include

Select the check boxes to include estimates with specific selector codes in the review queue.

Line Item Quality

Select the check boxes to include estimates with specific line item qualities in the review queue.

Price List

Select the Deviations check box to send estimates with price list deviations into the review queue. For Price Only Deviations, you can choose to identify estimates by the number of items with deviations or by the deviation amount.

Pricing Variations

Select the check box to send estimates with pricing variations into the review queue.

Item Rate Association

Select the check box to select if the rule is triggered on the Household or Contractor rate.

LINE ITEMS

This section allows you to create queue rules based on the line items included in estimates.

• Use the All Required feature to identify estimates with all the line items you enter here.
• Use the One Required feature to identify estimates with at least one of the line items you enter here.

You do not need to enter information into each menu and box. For example, you could use only the Category menu, sending estimates to the queue that have line items from a specific category.

1. Select a Country.
2. Select the Category for the line item. The Activity box will automatically be filled in.
3. Choose a Selector.
4. Choose whether the rule will look for a line item with a specific amount (equal to the number you enter) or a line item with more or less than a specific amount.
5. Choose whether the rule will look for items at the line item level or the estimate level. Line item rules will look for a single line item that matches the criteria. Estimate level rules will look for a total of line items that match the criteria.
6. Select whether the rule will look for corrected line items, not corrected, or neither.

To add more line item identifiers, click Add. To remove an identifier, click Delete.

GTA ITEMS

This section allows you to create queue rules based on an estimate's grand total adjustment percentage or value. The rule is triggered when one or both criteria are met.

Percent

Enter a percentage of the estimate subtotal. The rule is triggered if the estimate's grand total adjustment is greater than this percentage of the estimate subtotal.

Value

Enter a monetary value. The rule is triggered if the estimate's grand total adjustment is greater than this value.

THIRD PARTY

Filter Option

Select the check box to only include estimates that contain items in the fields selected below.

Accurence™ QualityAssist Score

Choose whether to include estimates with total scores greater than or less than a given value, or between two given values.

Accurence™ QualityAssist Score Sublevel

Choose whether to include estimates with an Accurence Process Score, or an Accurence Dollar Variation Score that is greater than or less than a given value, or between two given values.

MICA™ Score

Choose whether to include estimates with total scores greater than or less than a given value, or between two given values.

MICA™ Score Sublevel

Choose whether to include estimates with a MICA Process Score, or a MICA Dollar Variation Score that is greater than or less than a given value, or between two given values.

MoistureScore™

Choose whether to include estimates with total scores greater than or less than a given value, or between two given values.

MoistureScore™ Sublevel

Choose whether to include estimates with Key Process Indicators, Mitigation Process Management, or Response Time Management scores that are greater than or less than a given value, or between two given values.

OTHER

Notification Language Setting

Select a language in which to receive the notification. Languages include English (United States, English (Canada), French (Canada), German (Germany), and Spanish (Spain).

Client Approval

Select Manual to allow client reviewers to manually review and approve the estimates in the queue. Select Auto Approve to automatically approve the estimates in the queue based on the criteria of the rule.

Email To

Enter one or more email addresses (separated by commas). XactAnalysis sends an email to the specified addresses when an estimate triggers this rule and is sent to the Estimate Review Queue.

Automatically assign to

Enter the name of a reviewer to be specifically assigned or select (All). Estimates sent to the queue by this rule can be automatically assigned a reviewer that you specify here.