SAIF.Business.Claim.Payment operations and processes

This page is the operation catalog and cross-operation hub for SAIF.Business.Claim.Payment. The library exposes fourteen operations covering the low-level financial transaction ledger, payment posting/totals bookkeeping, benefit periods and schedules, payee management, refund and transfer adjustments, bill payment adjustments and payment deletion, state and federal awards, timeloss payment issuance, wage calculation worksheets, offset/supplemental wage calculation, medical bill and non-recurring payments, settlement and legal-order payments, and payment list/NDR data retrieval. Each operation's detailed, step-by-step logic lives in its own page under operations/.

Operation catalog

Operation	Intent	Trigger	Inputs	Outputs	Rules	Tables	SQL
Financial transaction and remark management	Create, retrieve, and remark the claim financial transaction ledger (header and detail lines)	clsFinancialTrans.NewFinancialTrans/GetFinancialTrans followed by property edits and Save()	Claim ID, transaction type, payee/detail lines, remark text	Inserted/updated CL_FINANCIAL_TRANS/CL_FINANCIAL_TRANS_DTL rows; persisted remark	BR-CP-001, BR-CP-004, BR-CP-005, BR-CP-006, BR-CP-007, BR-CP-008	CL_FINANCIAL_TRANS, CL_FINANCIAL_TRANS_DTL	SQL-020, SQL-054, SQL-055–SQL-065, SQL-101, SQL-102, SQL-124
Payment posting and totals management	Record insert-only payment postings and maintain append-only running claim payment totals per cost category	clsPaymentPosting.NewPaymentPosting/clsPaymentTotalManager retrieval, followed by Save()	Financial transaction sequence number, cost category, paid amount/days	Inserted CL_PAYMENT_POSTING row; new CL_PAYMENT_TOTAL rows for changed categories only	BR-CP-001, BR-CP-009, BR-CP-010	CL_PAYMENT_POSTING, CL_PAYMENT_TOTAL	SQL-023, SQL-024, SQL-076, SQL-077, SQL-078
Benefit period and schedule management	Maintain benefit periods, payment schedules, and pay remarks under a benefit payment	clsBenefitPeriodCollection.GetClaimBenefitPeriodCollection/clsBenefitSchedule retrieval, edits, Save()	Claim/benefit-payment ID, period dates and amounts, schedule fields, remark code	Inserted/updated/deleted CL_BENEFIT_PERIOD/CL_BENEFIT_SCHEDULE rows (not separately catalogued); persisted remark	BR-CP-001, BR-CP-011, BR-CP-012, BR-CP-013, BR-CP-014, BR-CP-015	DUAL	SQL-004, SQL-014, SQL-015, SQL-016, SQL-047–SQL-050, SQL-097–SQL-099, SQL-120–SQL-122
Payee management	Create and validate the polymorphic payee hierarchy (worker, beneficiary, employer, provider, recovery, support, attorney/other) attached to a payment	clsPayeeFactory.CreatePayee/clsPayeeCollection retrieval, edits, Save()	Payee type, claim/payment context, distribution percentage, support-order/award-info child data	Inserted/updated/deleted payee rows; persisted CL_STATE_AWARD_MONTHLY_PAYEE child rows	BR-CP-001, BR-CP-016, BR-CP-017, BR-CP-018, BR-CP-019, BR-CP-020, BR-CP-021, BR-CP-025	CL_STATE_AWARD_MONTHLY_PAYEE, CL_CLAIM_SUPPORT_ORDER	SQL-012, SQL-045, SQL-070, SQL-084–SQL-087, SQL-095, SQL-118
Refund adjustment processing	Reverse previously paid medical, HWR, non-disabling, worker-travel, third-party, or SAIF-check amounts	Caller constructs the concrete refund class and calls Save()	Claim data, candidate payments/service lines, refund amounts, remark	Negative-amount financial transactions and bill payment adjustments (delegated); external recovery/activity API requests (ND, third-party)	BR-CP-022, BR-CP-023, BR-CP-024, BR-CP-026, BR-CP-073	See Financial transaction and remark management	Delegated — see Financial transaction and remark management
Transfer adjustment processing	Move payments between claims (claim-to-claim), reassign to a different worker (full), or transfer between payees (other)	Caller constructs the concrete transfer class, selects payments, calls Save()	Source/target claim or worker, selected payments, transfer reason	Paired "From"/"To" financial transactions linked by TransferTransID (delegated)	BR-CP-022	See Financial transaction and remark management	Delegated — see Financial transaction and remark management
Bill payment adjustment and payment deletion	Record a claim-level adjustment against an audited bill line; delete released payments and every related payment	clsBillPaymentAdjustment.NewBillPaymentAdjustment; clsPaymentDeleter.DeletePayments	Financial transaction reference, bill/audit sequence, adjustment amount; selected payments to delete	Inserted CL_FINANCIAL_TRANS_BILL_ADJUST row; deleted CL_FINANCIAL_TRANS rows	BR-CP-026, BR-CP-027	CL_FINANCIAL_TRANS_BILL_ADJUST, CL_FINANCIAL_TRANS	SQL-017
State and federal award payment processing	Create, validate, approve, and pay Fatal/PPD/PTD state awards and federal award payments, including Social Security offsets	Adjuster creates/edits an award and approves generated award payments	Claim type, award type, effective/order/closure dates, worker data, offset data, payee selections	Persisted CL_AWARD/CL_AWARD_SS_OFFSET/CL_STATE_AWARD_MONTHLY_PAYEE rows; released award financial transaction	BR-CP-028–BR-CP-037	CL_AWARD, CL_AWARD_SS_OFFSET, CL_STATE_AWARD_MONTHLY_PAYEE, CL_BENEFIT_PAYMENT, CL_CLAIM_CLOSURE_ORDER, CL_FINANCIAL_TRANS	SQL-003, SQL-011–SQL-013, SQL-039–SQL-046, SQL-094–SQL-096, SQL-117–SQL-119
Timeloss payment issuance	Validate, schedule, and approve temporary-disability (TD) benefit payments	Adjuster enters/approves a clsTimelossPayment against benefit periods	Claim ID, benefit periods, payment category, payee list, issue date	Approved/released TD financial transaction (delegated); updated benefit period/schedule state	BR-CP-038–BR-CP-045, BR-CP-048	See Benefit period and schedule management	Delegated — see Financial transaction and remark management and Benefit period and schedule management
Wage calculation worksheet management	Record and finalize primary/secondary wage worksheets used to establish the statutory average weekly wage	Adjuster/auditor creates, edits, verifies, or finalizes a wage worksheet	Calculation method, pay-period unit, work-shift hours, paid amount, per-period earnings, secondary employer name	CL_CLAIM_TIMELOSS_CALCULATION/CL_SEC_TIMELOSS_CALCULATION header rows; period and earnings-grid rows; frozen statutory weekly wage	BR-CP-046, BR-CP-047, BR-CP-051, BR-CP-052	CL_CLAIM_TIMELOSS_CALCULATION, CL_SEC_TIMELOSS_CALCULATION, CL_WAGE_CALCULATION_PERIOD, CL_SEC_WAGE_CALCULATION_PERIOD, CL_WAGE_CALC_PERIOD_EARNINGS, CL_SEC_WAGE_CALC_PER_EARNINGS, CL_INJURY_CLAIM	SQL-018, SQL-025–SQL-030, SQL-051, SQL-066, SQL-079–SQL-081, SQL-088, SQL-089, SQL-100, SQL-103, SQL-106–SQL-108, SQL-112, SQL-113, SQL-123, SQL-128–SQL-130, SQL-132, SQL-133
Offset and supplemental wage calculation	Build per-period offset wage earnings and reallocate supplemental wage shortfalls to compute the timeloss offset amount	clsTimelossPayment.AssignOffsetWagesToPeriods computing offset/supplemental amounts	Wage type, hours/rate entries, average weekly wage, secondary employer earnings	CL_OFFSET_CALC_PERIOD/CL_OFFSET_WAGE_CALCULATION rows; CL_SEC_WAGE_EARNINGS rows; OffsetAmount/OffsetAmountAdjusted on benefit periods	BR-CP-051, BR-CP-053–BR-CP-056	CL_OFFSET_CALC_PERIOD, CL_OFFSET_WAGE_CALCULATION, CL_SEC_WAGE_EARNINGS, CL_SEC_TIMELOSS_CALCULATION	SQL-005, SQL-006, SQL-021, SQL-022, SQL-026, SQL-028, SQL-068, SQL-069, SQL-082, SQL-083, SQL-104, SQL-105, SQL-107, SQL-111, SQL-126, SQL-127, SQL-129–SQL-131
Medical bill and non-recurring payment processing	Validate, cost-code, and approve one-time payments (medical bill, burial, EAIP, employer refund, penalty)	Adjuster creates and approves a non-recurring payment type	Payee type, service/expense category, amount, dates	Released financial transaction (delegated); benefit-payment header row deleted after release	BR-CP-057–BR-CP-063	CLAIM_NON_DISAB_REIMB_MAX	SQL-053
Settlement and legal-order payment processing	Validate, approve, and release CDA, DCS, federal, and legal-order settlement payments	Adjuster creates a settlement payment and approves/releases it	Settlement total, payee distributions, order-approved date, claim jurisdiction	Released settlement transaction (delegated); claim status update (CDA close, DCS deactivation); updated CL_INJURY_CLAIM	BR-CP-025, BR-CP-064–BR-CP-070	CL_INJURY_CLAIM	SQL-109, SQL-110
Payment list queries and NDR claim data retrieval	Retrieve pending-approval/by-approver payment worklists with confidentiality masking; enforce payment authority limits; retrieve NDR claim amounts	Adjuster/approver opens a worklist; payment initiation/approval checks authority; a refund needs NDR claim amounts	Mail/approver ID, business function/amount, claim ID	Read-only masked payment-list rows; authority pass/fail; NDR claim amount figures	BR-CP-002, BR-CP-071, BR-CP-072, BR-CP-073	CLAIM_NON_DISAB_REIMB_MAX, CL_FINANCIAL_TRANS_DTL, CL_INJURY_CLAIM	SQL-067, SQL-073–SQL-075

Process flow diagram

The following diagram shows how the fourteen operations relate: the financial-transaction ledger and payment-posting/totals bookkeeping form the shared foundation that every payment-producing operation writes through; benefit periods, payees, awards, timeloss, wage calculations, non-recurring payments, and settlements each build on that foundation; and payment lists/authority checks/NDR data retrieval provide the read-side and cross-cutting authority gate.

flowchart TD
    Start([Adjuster initiates a payment-related action]) --> Foundation[Financial transaction<br>and remark management]
    Foundation --> Posting[Payment posting and<br>totals management]
    Start --> Periods[Benefit period and<br>schedule management]
    Start --> Payees[Payee management]
    Start --> Adjustments{Adjustment type?}
    Adjustments -->|Refund| Refund[Refund adjustment processing]
    Adjustments -->|Transfer| Transfer[Transfer adjustment processing]
    Adjustments -->|Bill adjustment/delete| BillAdj[Bill payment adjustment<br>and payment deletion]
    Refund --> Foundation
    Transfer --> Foundation
    Start --> Awards[State and federal award<br>payment processing]
    Awards --> Periods
    Awards --> Payees
    Start --> Timeloss[Timeloss payment issuance]
    Timeloss --> Periods
    Timeloss --> Wage[Wage calculation<br>worksheet management]
    Timeloss --> Offset[Offset and supplemental<br>wage calculation]
    Offset --> Wage
    Start --> NonRecurring[Medical bill and<br>non-recurring payment processing]
    Start --> Settlement[Settlement and legal-order<br>payment processing]
    Foundation --> Posting
    Awards --> Posting
    Timeloss --> Posting
    NonRecurring --> Posting
    Settlement --> Posting
    AuthCheck([Any payment initiate/approve]) --> PaymentList[Payment list queries and<br>NDR claim data retrieval]
    Refund --> PaymentList
    Posting --> Done([Payment released and posted])

Database interactions

The following table summarizes which operations read from or write to the database. Per-step SQL and table citations live in each operation's detail page under operations/.

Operation	SQL	Tables	Type
Financial transaction and remark management	SQL-020, SQL-054–SQL-065, SQL-101, SQL-102, SQL-124	CL_FINANCIAL_TRANS, CL_FINANCIAL_TRANS_DTL	Read / Write
Payment posting and totals management	SQL-023, SQL-024, SQL-076–SQL-078	CL_PAYMENT_POSTING, CL_PAYMENT_TOTAL	Read / Insert only
Benefit period and schedule management	SQL-004, SQL-014–SQL-016, SQL-047–SQL-050, SQL-097–SQL-099, SQL-120–SQL-122	DUAL (period/schedule/remark tables not separately catalogued)	Read / Write
Payee management	SQL-012, SQL-045, SQL-070, SQL-084–SQL-087, SQL-095, SQL-118	CL_STATE_AWARD_MONTHLY_PAYEE, CL_CLAIM_SUPPORT_ORDER	Read / Write
Bill payment adjustment and payment deletion	SQL-017	CL_FINANCIAL_TRANS_BILL_ADJUST, CL_FINANCIAL_TRANS	Insert only / Delete
State and federal award payment processing	SQL-003, SQL-011–SQL-013, SQL-039–SQL-046, SQL-094–SQL-096, SQL-117–SQL-119	CL_AWARD, CL_AWARD_SS_OFFSET, CL_STATE_AWARD_MONTHLY_PAYEE, CL_BENEFIT_PAYMENT, CL_CLAIM_CLOSURE_ORDER, CL_FINANCIAL_TRANS	Read / Write
Wage calculation worksheet management	SQL-018, SQL-025–SQL-030, SQL-051, SQL-066, SQL-079–SQL-081, SQL-088, SQL-089, SQL-100, SQL-103, SQL-106–SQL-108, SQL-112, SQL-113, SQL-123, SQL-128–SQL-130, SQL-132, SQL-133	CL_CLAIM_TIMELOSS_CALCULATION, CL_SEC_TIMELOSS_CALCULATION, CL_WAGE_CALCULATION_PERIOD, CL_SEC_WAGE_CALCULATION_PERIOD, CL_WAGE_CALC_PERIOD_EARNINGS, CL_SEC_WAGE_CALC_PER_EARNINGS, CL_INJURY_CLAIM	Read / Write
Offset and supplemental wage calculation	SQL-005, SQL-006, SQL-021, SQL-022, SQL-026, SQL-028, SQL-068, SQL-069, SQL-082, SQL-083, SQL-104, SQL-105, SQL-107, SQL-111, SQL-126, SQL-127, SQL-129–SQL-131	CL_OFFSET_CALC_PERIOD, CL_OFFSET_WAGE_CALCULATION, CL_SEC_WAGE_EARNINGS, CL_SEC_TIMELOSS_CALCULATION	Read / Write
Medical bill and non-recurring payment processing	SQL-053	CLAIM_NON_DISAB_REIMB_MAX	Read
Settlement and legal-order payment processing	SQL-109, SQL-110	CL_INJURY_CLAIM	Write
Payment list queries and NDR claim data retrieval	SQL-067, SQL-073–SQL-075	CLAIM_NON_DISAB_REIMB_MAX, CL_FINANCIAL_TRANS_DTL, CL_INJURY_CLAIM	Read (plus external claim-data API)

Refund and transfer adjustment processing, timeloss payment issuance, and medical bill/settlement payment release all delegate their final persistence to Financial transaction and remark management and Payment posting and totals management, so their own database interactions are not separately catalogued here beyond what is shown in each operation's detail page.

Stored procedure operations

Operations implemented in Oracle packages referenced by this library. All three packages below were referenced in code but not found during Oracle catalog retrieval (Stage 1b); the described behavior is inferred from VB call sites rather than verified package bodies.*

Operation	Description	Source	Link
Claim benefit period/schedule/payee/payment-list operations*	Insert, update, delete, and retrieval calls for benefit periods, schedules, remarks, award payee info, and payment lists.*	PK82394_CLAIM_BENEFIT.*	Details
Financial transaction persistence*	Insert, update, delete, and retrieval calls for the financial transaction header/detail ledger and payment postings.*	PK82343_FINANCIAL_TRANS.*	Details
Overpayment balance calculation*	Referenced by test-only code (see business rules notes on the BR-CP-003 citation); not confirmed against production call sites in this pass.	PK82395_OVERPAYMENTS.*	Details

Failure and edge-case behavior

• Optimistic concurrency (BR-CP-001) is the dominant failure mode across the ledger, posting, period, and payee operations: every persisting operation checks the affected row count and adds a DB contention error instead of throwing. Detailed per-operation behavior is documented on each operation page.
• Payment postings and payment totals are insert-only/append-only (BR-CP-009, BR-CP-010); there is no update path for a posted or totaled payment — corrections happen by posting an offsetting entry, not by editing history.
• Refund and transfer adjustments never modify CL_FINANCIAL_TRANS directly except through the shared financial-transaction save path; non-disabling and third-party refunds instead route entirely through external claim-data/activity APIs and never touch that table at all.
• Non-recurring payments (burial, EAIP, employer refund, penalty, medical bill) and settlements are released as financial transactions, not retained as CL_BENEFIT_PAYMENT rows, once approved (BR-CP-062) — any report querying that table for a released payment of these types will not find it.
• EAIP payment approval and legal-order payment approval sit at opposite ends of the authority spectrum: EAIP bypasses the standard awaiting-approval checks entirely (BR-CP-063), while legal-order payments can never be self-approved under any circumstance (BR-CP-067).
• Wage worksheet finalization discards all in-progress worksheets for the claim as a side effect (BR-CP-046), and only Final secondary worksheets feed the offset/supplemental wage calculation (BR-CP-051) — an in-progress secondary worksheet is invisible to payment until finalized.
• PK82394_CLAIM_BENEFIT, PK82343_FINANCIAL_TRANS, and PK82395_OVERPAYMENTS could not be located in the Oracle catalog, so the stored-procedure behavior documented across all fourteen operations is derived from VB call sites and parameter shapes rather than verified package bodies.*
• The BR-CP-003 citation of pk82395_overpayments.getRecoverableBalance was found only in test-only code during this pass; the confirmed production equivalent is clsSettlementPayment.CheckApprovalErrors against ClaimData.OverpaymentBalance (BR-CP-025; see also the business rules notes).

Related documentation

• Index
• Overview
• Architecture
• Dependencies
• Business rules
• Database tables
• SQL catalog
• Procedures
• API reference

Note: Statements marked with * were inferred from code structure, naming conventions, or contextual evidence where direct confirmation was not available in source artifacts.

Sources

• Business\SAIF.Business.Claim.Payment\FinancialTransaction\clsFinancialTrans.vb
• Business\SAIF.Business.Claim.Payment\FinancialTransaction\clsFinancialTransCollection.vb
• Business\SAIF.Business.Claim.Payment\FinancialTransaction\clsFinancialTransDtl.vb
• Business\SAIF.Business.Claim.Payment\FinancialTransaction\clsFinancialTransDtlCollection.vb
• Business\SAIF.Business.Claim.Payment\FinancialTransaction\clsFinancialTranRemark.vb
• Business\SAIF.Business.Claim.Payment\FinancialTransaction\clsPaymentPosting.vb
• Business\SAIF.Business.Claim.Payment\FinancialTransaction\clsPaymentPostingCollection.vb
• Business\SAIF.Business.Claim.Payment\FinancialTransaction\clsPaymentTotalManager.vb
• Business\SAIF.Business.Claim.Payment\Periods\clsBenefitPeriod.vb
• Business\SAIF.Business.Claim.Payment\Periods\clsBenefitPeriodCollection.vb
• Business\SAIF.Business.Claim.Payment\Payments\TimelossPayments\clsBenefitSchedule.vb
• Business\SAIF.Business.Claim.Payment\Payments\TimelossPayments\clsBenefitScheduleCollection.vb
• Business\SAIF.Business.Claim.Payment\clsBenefitRemark.vb
• Business\SAIF.Business.Claim.Payment\Payees\clsPayeeBase.vb
• Business\SAIF.Business.Claim.Payment\Payees\clsPayeeFactory.vb
• Business\SAIF.Business.Claim.Payment\Payees\clsPayeeCollection.vb
• Business\SAIF.Business.Claim.Payment\Payees\clsAwardPayeeInfo.vb
• Business\SAIF.Business.Claim.Payment\Payees\clsSupportPayee.vb
• Business\SAIF.Business.Claim.Payment\Adjustments\clsAdjustmentBase.vb
• Business\SAIF.Business.Claim.Payment\Adjustments\Refunds\clsRefundAdjustment.vb
• Business\SAIF.Business.Claim.Payment\Adjustments\Transfers\clsTransferAdjustment.vb
• Business\SAIF.Business.Claim.Payment\Adjustments\clsBillPaymentAdjustment.vb
• Business\SAIF.Business.Claim.Payment\Adjustments\clsBillPaymentAdjustments.vb
• Business\SAIF.Business.Claim.Payment\Adjustments\clsPaymentDeleter.vb
• Business\SAIF.Business.Claim.Payment\Payments\StateAwardPayments\clsAward.vb
• Business\SAIF.Business.Claim.Payment\Payments\StateAwardPayments\clsAwardCollection.vb
• Business\SAIF.Business.Claim.Payment\Payments\StateAwardPayments\clsAwardSSOffset.vb
• Business\SAIF.Business.Claim.Payment\Payments\clsFederalAwardPayment.vb
• Business\SAIF.Business.Claim.Payment\Payments\TimelossPayments\clsTimelossPayment.vb
• Business\SAIF.Business.Claim.Payment\Payments\TimelossPayments\clsFederalTimelossPayment.vb
• Business\SAIF.Business.Claim.Payment\Wage and Job\clsClaimTimelossCalculation.vb
• Business\SAIF.Business.Claim.Payment\Wage and Job\clsSecTimelossCalculation.vb
• Business\SAIF.Business.Claim.Payment\Wage and Job\clsInjuryClaimWageAndJob.vb
• Business\SAIF.Business.Claim.Payment\Payments\TimelossPayments\clsOffsetWageCalculation.vb
• Business\SAIF.Business.Claim.Payment\Payments\TimelossPayments\clsSupplementalWages.vb
• Business\SAIF.Business.Claim.Payment\Payments\MedicalBillPayments\clsMedicalBillPayment.vb
• Business\SAIF.Business.Claim.Payment\Payments\NonRecurringPayments\clsNonRecurringPaymentBase.vb
• Business\SAIF.Business.Claim.Payment\Payments\SettlementPayments\clsSettlementPayment.vb
• Business\SAIF.Business.Claim.Payment\Payments\SettlementPayments\clsCDAPayment.vb
• Business\SAIF.Business.Claim.Payment\Payments\SettlementPayments\clsDCSPayment.vb
• Business\SAIF.Business.Claim.Payment\clsPaymentListCollection.vb
• Business\SAIF.Business.Claim.Payment\clsPaymentUser.vb
• Business\SAIF.Business.Claim.Payment\Adjustments\Refunds\clsNdRefund.vb