Benefit determination is an automated process that is executed by Smart Claims Engine in the benefit determination module (CE_DetermineBenefit), one of several sequence modules required to support the application’s adjudication process.

To configure the benefit determination module.

1. Select the Designer Studio > Claims Engine > Claims Engine Configuration landing page.

   

   All processing modules are displayed on the Claims Engine Configuration landing page.

2. Click the CE_DetermineBenefits hyperlink.

• Business user information