PCM - Stuck Adjudication Batches

Issue:

Occasionally, an Adjudication Batch seems to be stuck – the run status will show “In Adjudication” longer than expected for the usual timing for runs of similar size.

Resolution:

If this is a relatively small run, find the Run ID in the Active Runs tab of the Adjudication Processing screen and click on “Clear Adjudication Run”.  Once it is back in an entered status, click on “Adjudicate” again. This should clear out any hang-ups due to interrupted connections to the database or locks on data and allow the batch to finish processing.

If this is a very large adjudication batch where hours could be lost clearing and re-adjudicating without knowing if it is truly stuck or if it is just slow, it’d be best to have IT check directly in the database to see if claims are still adjudicating. The following script can be used to check the adjudicated claim lines in the batch:

select

c.claim_ud

,cp.claim_procedure_id

,cps.claim_procedure_status_ud

,aj.adj_run_ud

       from claim_procedure as cp

              join adj_run as aj

              on aj.adj_run_id = cp.adj_run_id

              join claim_procedure_status as cps

              on cps.claim_procedure_status_id = cp.claim_procedure_status_id

              join claim as c

              on c.claim_id = cp.claim_id

where aj.adj_run_ud = 'enter Run ID here'

and cp.claim_procedure_status_id is not null

order by c.claim_ud

After entering the Adjudication Run ID in the above query, the results will show you all the claim lines in the run that have finished adjudicating.  Run it again a few minutes later to see if you get more rows returned. If you do, the run is still processing and should be left alone.

If you want to see how many claim lines are still left to adjudicate, you can alter the above script to “is null” in place of “is not null” and it will return all the unprocessed claim lines.

If there are only a few claims left unprocessed and it appears adjudication is stuck, open these claims in the UI to see if there is any required data missing that would halt adjudication. Missing or bad data is rare, however, and usually a stuck run is due to some type of connection hiccup or data lock that is resolved by clearing and re-adjudicating the run.