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Emergency Case Claims Process Guide: Remove a Doctor from an Emergency Case Claim Workflow

1. Overview: Detaching a Doctor from the Claim

This guide focuses on the Remove a Doctor from an Emergency Case Claim workflow. If a doctor no longer wants to be on the claim - for example, they rejected the case - you can remove them. This is typically followed by adding a new doctor so the claim still has a valid attending doctor.

1.1. What This Workflow Does

The Remove a Doctor from an Emergency Case Claim workflow detaches the doctor from an existing emergency claim via DELETE /api/v1/claims/doctors, identified by the claim's consent_token.

1.2. Why This Workflow Is Critical (The "Why It Matters")

Being able to remove a doctor keeps the claim accurate:

• Reflects Reality: A doctor who declined or is no longer involved should not remain on the claim.
• Enables Replacement: Removing the current doctor clears the way to add the correct one.
• Maintains Claim Integrity: The attending doctor on the claim should match who actually consents to the emergency care.

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2. Workflow Details: Remove a Doctor from an Emergency Case Claim

2.1. Workflow Description: Step-by-Step System Behavior

When a request to remove a doctor comes into the system, here is what unfolds:

1. Input Reception: The system receives the claim's consent_token.
2. Claim Validation: The system confirms the consent_token belongs to an active emergency claim.
3. Detachment: The doctor is removed from the claim.

2.2. Key Validations: Our System's Essential Checks

• Active Claim Token:
  • What it means: The consent_token must belong to an open emergency claim.
  • Why it's important: Doctor changes can only be made on an active emergency case.

2.3. Workflow Data Dictionary: What Information We Work With

Field Name	Description	Data Type	Required	Purpose
consent_token	The token returned when the emergency claim was created.	string	Yes	Identifies the emergency claim to remove the doctor from.

2.4. Expected Outcomes from this Workflow

• Success: The doctor is removed from the emergency claim (204 No Content).
• Failure: Invalid claim token - the consent_token is invalid or the claim is closed.

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3. Critical Success Factors for Remove a Doctor Integration

• Add a Replacement: After removing a doctor, attach a valid replacement so the claim can progress.
• Use the Claim's consent_token: Operate against the same token used throughout the case.

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4. Related Resources

• Emergency Case Claims Process Overview
• Add a Doctor to an Emergency Case Claim
• Resend Doctor Consent
• Claims & Preauths API Reference