This chapter describes defaults and samples that are set up and ready for your use. You can use these as a basis for implementing and extending the Pega Smart Claims Engine for Healthcare application.

The topics include:

• Smart Claims Engine overview
• Application rules
• System administrator account
• Ruleset hierarchy
• Data classes
• Work object naming conventions
• Default workbaskets
• Default operators, access groups, and portals
• Predefined organizations, divisions, and units
• Predefined access roles and privileges
• Claim actions for users

• Pega Smart Claims Engine Implementation Guide