Extending message validation
Copy the following rules in your ruleset to extend the validations of the transaction, information receiver (Provider), and Subscriber submitted in the message:
Pega Foundation for Healthcare
Name | Type | Description |
CheckLimit | Activity | Validates for number of benefit requests in a single transaction. The threshold set in the Foundation is 25. |
SetAAA | Data Transform | Sets AAA segment information when Check Limit validation fails. |
CheckProviderOnFile | Activity | Searches for Information Receiver Provider information based on Provider ID. |
SetProviderReceiverLevel | Data Transform | Maps AAA segment information when Provider validation fails (provider not found). |
SubscriberOnFile | Activity | Searches for Subscriber in membership system. |
SetForNoMemberData | Data Transform | Maps AAA segment information when Subscriber validation fails (subscriber not found). |
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