Clarification on BCDA v3 Claim Updates for Partially Adjudicated Claims

[Ashvani goyal]

Hello BCDA Team,

We have a question regarding claim updates in BCDA V3.

When a claim is initially received in a partially adjudicated state and is later updated to a fully adjudicated state, could you please clarify what information is expected to change in the subsequent ExplanationOfBenefit resource?

Specifically, we would like to understand:

• Which fields are expected to change when the claim reaches its final state?

• Is the lastUpdated timestamp the only field that changes, or are there other claim-level and line-level fields that may also be updated?

• Can claim line items be added, removed, or modified during the final adjudication?

• Which field(s) should be used to reliably identify that the latest version of the claim replaces the previous version?

• Is there a specific indicator in BCDA V3 that identifies whether a claim is in a final adjudication/payment state?

This information will help us correctly implement our incremental processing logic and determine when a previously received claim should replace an earlier version.

We appreciate your guidance.

Thank you,
Ashvani Goyal

[Ashvani goyal]

We are still looking for your response.

Thanks,
Ashvani Goyal.