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Extending message validation

Updated on April 23, 2021

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
CheckLimitActivityValidates for number of benefit requests in a single transaction. The threshold set in the Foundation is 25.
SetAAAData TransformSets AAA segment information when Check Limit validation fails.
CheckProviderOnFileActivitySearches for Information Receiver Provider information based on Provider ID.
SetProviderReceiverLevelData TransformMaps AAA segment information when Provider validation fails (provider not found).
SubscriberOnFileActivitySearches for Subscriber in membership system.
SetForNoMemberDataData TransformMaps AAA segment information when Subscriber validation fails (subscriber not found).

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