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Step 4: Integrating and managing X12 EDI messages

Updated on September 18, 2020

Pega Foundation for Healthcare provides a pre-configured File Service rule instance called X12file.X12.X12Inbound that reads the X12 message input file and calls the activity X12ParseMessageStart to start the processing of the message file.

  1. Configure an appropriate MQ or File Listener rule with all listener properties.
  2. Configure appropriate MQ / File Service rule to associate with the Listener rule (see example for File Service rule mentioned above.
  3. Ensure the Service rule calls the X12ParseMessageStart rule as the Activity.
  4. The parsed X12 message is available on the clipboard page specified Service rule e.g. X12Message.
  5. Extend the process to map to an appropriate work object as required.
Note: The work object mapping for the X12 837 claim transaction is configured in Pega’s Healthcare Claims Repair and Smart Claims Engine applications. Similarly, the mapping of the X12 278 Healthcare Service Review and Response is configured in the Care Management application.

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