Changing your application perspective

When you create your application, you select either payer or provider perspective. However as an organization, you might want to change the perspective.

If a provider organization used an earlier version of the application and did not customize the labels, for example, changing Member to Patient, they might now choose the Provider option. In this case, when changing to the provider perspective, all references to member are automatically changed to patient.

1. In the header of Dev Studio, click ConfigureCare Management Configuration.
2. Click the Other settings tab.
3. In the Application perspective field, click Provider.
4. Click Save and then click Close.

Configuring the patient verification setting

You can specify whether you want to perform Health Insurance Portability and Accountability Act (HIPAA) verification as part of your Schedule call and Schedule assessment tasks. This compliance activity ensures the protection of member health and identity information.

Because some organizations have other processes to ensure HIPPA compliance, this setting gives an organization the opportunity to remove the verification step from the Schedule call and Schedule assessment tasks.

1. In the header of Dev Studio, click ConfigureCare Management Configuration.
2. Click the Other settings tab.
3. In the Require member verification in task field, click an option to specify whether or not you want to perform member HIPAA verification as part of your tasks.
4. Click Save.

Adding members to the care team list

During implementation, you might want to add more user roles to the default list of internal care team member roles who interact with the patient. For example, your non-clinical care management representatives might be asked to engage with patients. In this example, you add the role of CM User Rep to the internal care team list.

1. In the header of Dev Studio, click ConfigureCare Management Configuration.
2. Select the Access roles for internal team tab, and then click the Add a row icon below the Access role field.
3. In the Access role field, select a name from the list.
4. Click Save.
   An individual must be assigned to the specified access role in order for the access role to be displayed in the Pega CM Care Manager portal. For more information, see Access roles.

Extension rules for the Care Management Configuration page

Based on your organization's needs, you can extend the configuration rules and save them to your application rulesets. For example, you might want to add a new case type or you might want to add the client name in the other settings.

1. In the header of Dev Studio, click ConfigureCare Management Configuration.
2. In the following table, use the section rules in the PegaHCCMF-Landing class (shown in the table below) that correspond to the tab of the configuration page that you want to extend.

You can use the following extensions to manage additional configurations such as a new case type or work basket configurations through the Care Management Configuration page. The details that you configure on the landing page are accessed through the Declare_CM_ENV data page in the application.

Tab name	Rule name
Work classes	CMAConfigWorkClass_Ext
Rule classes	CMAConfigRuleClass_Ext
Data classes	CMAConfigDataClass_Ext
Accelerator classes	CMAConfigAccelClass_Ext
Work queues	ConfigCMAWorkbaskets_Ext
Work queues	ConfigCMAWorkGroups_Ext
Work object status	ConfigCMAWorkStatus_Ext
Other settings	ConfigCMAOtherSettings_Ext
Patient identifiers	PatientIdentificationsList_Ext
Access roles for internal team	CareTeamAccessRolesList_Ext
Access roles for PCM	PCMAccessRolesList_Ext
Patient events	PatientEvents_Ext
SDOH categories	SDOHCategories_Ext

The details that you configured on the landing page are saved in the PegaHCCMF-Data-Settings instance. Any new configurations that you add on the landing page by using the above extension points should be saved in the PegaHCCMF-Data-Settings data instance so that they are available for use in the application. Use the following extension data transforms to update the new configuration details in the PegaHCCMF-Data-Settings data instance.

Rule name	Rule class
SetConfigValue_Ext	PegaHCCMF-Landing
SaveApplicationSettings_Ext	PegaHCCMF-Landing
LOAD_CM_ENV_Ext	PegaHC-Care-Env