Module 05
Claims Management
Claims processing is one of the biggest operational wins in this proposal. What is currently a multi-system, partially manual process — franchisee submits via Zendesk or email, reviewer acts in a spreadsheet, someone manually creates an ACH file — becomes an end-to-end automated workflow that routes approved claims directly to AP.
"Franchisees submit claims for Zee/MRA reimbursement with supporting receipts; marketing users review, reject, approve, or request more information; approved claims push to Dynamics GP for payment."
The Claims Problem
Today's claims process has three distinct failure points. First, the submission experience is inconsistent — US and Canadian franchisees use different channels, with Canadian claims going through Zendesk and US claims going through a variety of ad hoc methods. Second, the review workflow is manual and spreadsheet-driven, creating bottlenecks when review volume is high. Third, the step between approval and ACH payment requires manual file creation — someone has to build the ACH file, hand it off, and confirm it was transmitted correctly.
Every approved claim requires someone to manually create or update an ACH file and hand it to AP for processing. This is a manual step in a workflow that should be entirely automated. It creates delays between approval and payment, introduces errors, and creates a single-person dependency ("the person who does the ACH file"). Marketing Central eliminates this step entirely — approved claims route to GP automatically.
Self-Service Submission
Franchisees submit claims directly in Marketing Central through a guided questionnaire flow. The submission process is designed to collect the right information upfront, reducing back-and-forth during review.
Select Fund Type & Office
The franchisee selects whether the claim is against Zee Funds or MRA Funds, and which office the spend was for. Their available balance for the selected fund is displayed immediately — they cannot submit a claim for more than their available balance.
Describe the Expense
A guided questionnaire collects the expense type (from a configured list of approved marketing activity categories), the vendor or service provider, the date of service/purchase, and a brief description. The category selection drives what documentation is required in the next step.
Upload Supporting Documentation
The franchisee uploads receipts, invoices, or proof-of-completion depending on the expense type. The platform accepts PDF, JPG, and PNG files. Multiple documents can be attached to a single claim. Future phase: OCR-based receipt parsing to auto-extract vendor, date, and amount.
Enter Amount & Banking Details
The franchisee enters the claim amount (capped at their available balance — the over-submission guard prevents submitting more than they have). Banking information for ACH payment is on file from account setup; the franchisee confirms the correct account for this disbursement.
Review & Submit
A summary of the claim is shown before final submission. Upon submission, the claimed amount is moved from Available to Open Claims in the fund ledger, preventing double-spending. The franchisee receives a confirmation email with their claim reference number and a link to track status.
Reviewer Workflow
Claims enter a review queue in Marketing Central where Liberty's marketing team reviews, acts on, and manages each submission. The review interface is purpose-built for efficient claims processing — not a generic ticket system.
Four Review Actions
Reviewers can: Approve (trigger AP routing), Deny (return funds to available, notify franchisee with reason), Needs Change (return to franchisee for correction or additional documentation without closing the claim), or Hold (flag for later action without advancing or closing).
Configurable Review Codes
Each action (especially Deny and Needs Change) requires selection of a reason code from a configurable list. Codes are managed by admin — Liberty controls the taxonomy. Codes appear in the franchisee-facing notification and in the audit log.
Reviewer Editing & Amount Adjustment
Reviewers can edit the claim amount before approving — common when the submitted amount includes ineligible items or the receipt shows a lower qualifying total. The revised amount is logged, and the franchisee is notified of any adjustment with an explanation.
Internal Notes (Reviewer-Only)
Reviewers can attach internal notes to a claim that are visible only to other reviewers and admins — never to the franchisee. These notes persist through the claim lifecycle and are included in the audit log. Used for escalation notes, compliance flags, or coordination between reviewers.
Create Claim on Behalf
Marketing and Admin users can create a claim on behalf of any franchisee — used for Canadian franchisees who may be less familiar with the self-service flow, or for any office where assistance is appropriate. The claim is attributed to the franchisee's office; the creator is logged in the audit trail.
Direct-to-AP Routing
When a claim is approved, Marketing Central triggers the AP routing automatically. No human handoff. No manual file creation. The manual step that currently sits between "approved in a spreadsheet" and "ACH payment issued" is eliminated.
GP Integration for Disbursement
Approved claims are pushed to Dynamics GP via the integration layer with all required AP fields: franchisee entity, bank routing and account number, amount (in correct currency), period, and claim reference ID. GP processes the ACH disbursement on its normal schedule.
The disbursement cadence is configurable — Liberty can set weekly or bi-weekly AP runs. All approved claims pending disbursement are included in the next run automatically.
Payment Confirmation Callback
When GP confirms that the ACH payment has been issued, it sends a confirmation back to Marketing Central. The claim is marked Paid. The franchisee's fund ledger is updated. The franchisee receives a payment confirmation notification. The loop closes without any manual intervention.
ACH output files are generated separately for US and Canadian offices, in the formats required by the respective banking systems.
This is not a small efficiency improvement. It is the elimination of a class of manual work that currently requires someone to own it, do it correctly, every disbursement cycle. That person's time is returned. The error rate associated with manual file creation drops to zero. The time between approval and payment shortens to the length of the next GP processing cycle.
Canada Unification
Canadian franchisees currently use Zendesk to submit claims — a separate channel with a separate tracking system and a different reviewer experience. This creates two operational workflows where there should be one.
Canadian franchisees submit claims via Zendesk tickets. Reviewers manage a separate Zendesk queue in addition to the US claims process. There is no integration between Zendesk and GP — approved claims still require manual ACH file creation. UPS shipping for Canada is tracked in a separate manual spreadsheet.
Canadian franchisees use the same Marketing Central claims interface as US franchisees. Reviewers see all claims in one queue, with country clearly indicated. Approved Canadian claims route to GP for CAD ACH disbursement automatically, using a separate ACH file format for Canadian banking. The Zendesk queue is retired. The UPS spreadsheet is retired.
The "create on behalf" capability in the reviewer workflow provides a migration path for the transition period — Liberty's team can submit claims on behalf of Canadian franchisees who need help adapting to the new system, without maintaining a parallel process indefinitely.