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Updating products

Updated on January 26, 2021

During the product update, you select products to apply one of these target actions: update, replicate an existing, or create a new version of an existing product.

When you update a product, the product receives merged information from the existing product and the parent product template. This data includes metadata, benefit categories, coverage ranges, and coverage values.

Replicating an existing product involves creating a new product that you copy from an existing product. After the replication, the replicated product is no longer connected to the existing product.

The system automatically increments the version of the new product as either a major or minor version based on whether you changed the effective and end dates.

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Before you begin: Complete the steps in Launching Smart Update in the Configuring and launching Smart Update section.

Selecting products and target actions

Select the target actions for your products that you are updating.

  1. In the Select an entity field, click Product, and then click Continue.
  2. On the Search product templates page, click Add products.
  3. In the Add products dialog box, complete the fields as needed for your search, and then click Search.
    For example: You can search for products by the product name or by the product template name on which products were built.
  4. In the search results list, select the products that you want to update, and then click Submit.
  5. To add more products to update after the initial selection, in the Selected products section, click Add products, and complete steps 3 and 4.
  6. Click Continue to select the target actions.
  7. Determine which target actions you are applying to your selected products. For example, you might update the selected products.
  8. In the Select target action step, in the Target action list, select an action.
    Select only one action for your products. Do not mix actions in the Smart Update case.
  9. Select one or more products, complete the fields that are appropriate for your business needs, and then click Apply.
    Based on the selected target action, other fields are displayed for completion. For example, you can give your target entity a new name or select another version of the product template on which the target entity is built, if another version is available and applicable. When you replicate a product, you must give the product a new name because after the replication, the replicated product is no longer connected to the existing product.
  10. Review the information, and then click Submit.
  11. Click Refresh.
  12. In the Assignments section, click Begin to review your product.

Reviewing the selected products

Your selection of the target action for a product determines your review.

On the Review created products page, you can review all the information that is related to your target entity. Note any information that you want to add or modify and any items that you need to reconcile. You can make these changes in Configuring products in this section.

For updates to products, you can click the link for the target entity and review existing product metadata, cost shares, networks, benefits, and benefit categories for the updated versions. When you update a product, the new product receives merged information from both the parent product and the product template. In this case, you see the merged information.

No Warning icons are displayed next to your product Click Submit.
A Warning icon is displayed next to the product with information for your configurationHover over the icon, note the information, and then click Submit.
A Warning icon is displayed next to your product with an error message
  1. Hover over the Warning icon next to your product.
  2. Determine whether you want to withdraw or fix the error
  3. If you do not want to modify the product or you cannot fix the error, withdraw the Smart Update case:
    1. Click Actions Withdraw.
    2. If Withdraw is not an available action, on the Actions menu, click Review, and then click Actions again.

      Withdraw is now an available action.

  4. Based on the warning message, if you determine that you will fix the issue later, for example, adding data to the Market segment field, continue this Smart Update case and add the data during subsequent steps or later when convenient for you.
  5. If you want to correct the error in the straight-through processing flow, fix the issue, and then return to the Smart Update flow.
  6. To resolve other errors, repeat steps 1 through 4.
A Warning icon appears in the Manual review column of the item because you have items that have conflicts due to the merged data of the product and product template
  1. Hover over the icon to display the warning.
  2. Note the items that are indicated in the warning.

    During product configuration, you can make changes in any of the three tabs of metadata, benefit categories, and coverages information. For more information, see Configuring products in this section.

  3. Click Begin.

    The second review screen is displayed.

  4. Click Submit.

    Example: The following list shows items that you might need to reconcile. You can reconcile these items on the Configure Coverages page:

    • If a copayment for an existing product is not available (N/A) and the copayment for the new product is not available (N/A), but the product template has a range of copayments from $10 to $50
    • If a product shows not available for deductibles, but the product template has a range of values
    • If a product uses the embedded calculation type for deductible and out-of-pocket values and the product template uses the policy type calculation method
    • If a conflict exists between the coverage for a stand-alone benefit and the coverage for the same benefit within a grouper

Configuring products

During product configuration, you can configure metadata, benefit categories, and coverages. You might perform one or more of these tasks in any order or you might not perform any of them.

Before you begin: Review About batches in the Batches and target actions.

Configuring product metadata

Define the product metadata batch by adding the products to the batch and then selecting the metadata options that you are changing.

  1. On the Configure products page, click the Configure Metadata tab, and then click the Add product batch link.
  2. To rename the default batch name, click the Edit icon, and then enter the new name.
  3. If you want to copy the batch data from another batch, click the Copy batch data icon, and then choose an already configured batch.
  4. Expand the batch.
  5. Click the Add products to batch link.
  6. In the Select products for batch dialog box, select the products that you want to update with this batch, and click Submit.
    You can use the Filter by fields to display a subset of the selected products. For example, if you select ten products for update, but want to change the coverage only for Small group products, filter by Market Segment and select only those products for this batch.
  7. Click Submit.
  8. Click Define metadata to make your changes to the metadata.
  9. In the list on the left side of the Edit product metadata page, select the option that you want to change, and then select the action in the list on the right side of the page.
    For example, you might want to add a new coverage level, such as Employee + Children, to some products and plans.

    If you make a market segment change that applies to all 10 products, for example, a change from Large group market segment to Medium group market segment, define a product metadata batch, select all the products, and then remove the Large group market segment. Then define another product metadata batch, select the same products, and add the Medium group market segment. These changes apply to all 10 products.

    Some fields where you can select multiple options, for example Coverage level, have the following options:

    Append - The value that you select is added to the existing values

    Replace - The value that you select replaces the existing value

    Remove - The value that you select is removed

    Other fields where you can select only one option, for example Product line, have the actions Replace or No change. No change means that the existing value remains.

    The Exchange level field shows the actions of No change, Replace, or Remove.

  10. Complete the fields on the Edit product metadata page, and then click Submit.
  11. On the Configure products page, click Save.
  12. Do one of the following:
    • Follow the steps in Configuring product benefit categories in this section.
    • Follow the steps in Configuring coverages for your product in this section.
    • If you are finished with configuration, click Submit.

Configuring product benefit categories

Define the benefit category batch by adding the products to the batch and then defining the benefit categories and adding benefits.

If you change the benefit category within the Smart Update feature, Smart Update updates only the existing benefit categories that come from the existing or the new product, per your configuration in the batches.

  1. On the Smart Update page, click Begin.
  2. On the Configure product template page, click the Configure Benefit Categories tab.
  3. Click the Add product batch link.
  4. To rename the default batch name, click the Edit icon, and then enter the new value.
  5. To copy the batch data from another batch, click the Copy batch data icon, and then choose an already configured batch.
  6. On the Configure products page, click the Configure Benefit Categories tab, and then on the right side of the window, click the Add products to batch link.
  7. In the Select products for batch dialog box, select the products that you want to update with this batch, and then click Submit.
  8. On the right side of the window, click Define benefit categories, and then configure the categories:
    1. In the Define benefit categories dialog box, click Add benefit category.
    2. In the Benefit category list, enter a benefit category name, and then select an item.
    3. In the Update type field, select an option that describes the change that you want to make, for example, Add.
    4. In the Benefits and Groupers section, click the Add link and select Benefit or Grouper.
    5. In the Benefits and Groupers section, enter a benefit or grouper name, and then click the item that you want to update.
    6. To add other benefits or groupers, repeat steps c through e.
    7. Next to the benefit that you want to make the default benefit of the benefit category, click the Set as default display icon.
    8. Click OK.
  9. In the Define benefit categories dialog box, expand the benefit category name, and click Add.
  10. Select Benefit.
  11. In the Benefits and Groupers list, enter a benefit name, and then select the benefit that you want to update.
  12. To make the benefit the default benefit in the category, click the Set as default display icon to the right of the benefit.
    You must set one benefit in each benefit category as the default benefit.
  13. Click Submit.
  14. To define additional benefit categories and benefits, repeat steps 3 through 13.
  15. After completing your product configuration, click Submit, and then view the Review page.

Configuring coverages for your products

Define the coverage batch by selecting the entity to which you want to update coverage. Then select the products and networks to which the updated coverage will apply.

For example, based on world conditions, you might want to add a new benefit, such as Home Delivery of Meals during a flu epidemic, to your products for the current year. You create the benefit by using the links in the navigation pane of Pega Product Composer for Healthcare. You can then use Smart Update to add the benefit to the benefit set, product template, product, and plan and update the coverage.

You also configure product coverage if you want to change the deductibles and out-of-pocket values at the network level for your products.

Note: If you are changing the deductibles and out-of-pocket values at the network level, the products in the coverages batch must have the same calculation method. For information on calculation methods, see Configuring cost shares and accumulators for a new product in the Products section.

If you need to change the calculation method for a product, on the Configure Coverages tab, select Product, and then add the products for which you want changes. Then change the calculation method and define values.

  1. On the Smart Update page, click Begin.
  2. On the Configure products page, click the Configure Coverages tab, and then click Add product batch.
  3. To rename the default batch name, click the Edit icon, and then enter the new name.
  4. If you want to copy the batch data from another batch, click the Copy batch data icon, and then choose an already configured batch.
  5. Expand the batch name.
  6. In the Coverage applies to list, select the entity for which you are updating coverage within the context of the product. Based on the selection in this list, different sections are displayed on this page.
    For this example, select Benefit. If you are changing network coverage, on the Configure Coverages tab, select Network, and then add the networks for which you want changes. Then you can define the coverage.
  7. Expand the Select benefits section of the page, and then click the Click to add benefits icon to add the benefits.
  8. In the Add benefits dialog box, complete fields for your search, select the benefits that you are updating, and then click Submit.
  9. Expand the Select products section of the page, and then click the Click to add products icon to add the products.
  10. In the Add products dialog box, complete fields for your search, select the products that you are updating with the benefit change, and then click Submit.
  11. Expand the Select networks section of the page, and then click the Click to add networks icon to add the network names.
  12. Select the network names, and then click Submit.
  13. Click Define coverage.
  14. On the Configure coverage page, complete the updates to the coverage fields, and then click Submit.
    The following are the default values:

    No Change - The entity has the inherited values and the values do not change.

    Restore inheritance - The coverage value follows normal inheritance rules.

    Update coverage - The value that you enter overwrites the value on the product.

    ​​​​You can also copy values of one network to another network on this page.

  15. On the Configure products page, click Submit.

Reviewing updated products

You can review the updated products by clicking on the items under the Products and Configuration tabs.

  1. Click Refresh.
  2. Click Begin.
  3. Based on your selections, do one of the following:
    • Reconfigure products See Reconfiguring products and Configuring products in this section.
    • Send for approval See Sending product updates for approval in this section.
    • Update plans See Updating plans.

Reconfiguring products

Modify some values, for example, for a product or network, or fix some errors that you noted when you reviewed the products.

  1. On the Configure products page, create new batches.
  2. Click Reconfigure products.
    You add new batches (ongoing batches) for any changes that you want to make. You cannot modify the batches that you previously created because they have been submitted and processed by the system before the review. They are called processed batches.
  3. After you complete your changes to information on any of the three tabs, click Submit, and then review the products again.
  4. Based on your business, determine your next step:
    • Send the product updates for approval.

      You might have all products approved before you start using Smart Update for plans.

    • Begin plan updates.

      If you found errors in the product and plan, and then fixed them, you might begin updates to the plan.

Sending the product updates for approval

  1. From the Review updated product page, click Send for Approval.
    The approval request is routed to the manager.
  2. As the manager, in the Pega Case Manager portal, click ActionsApprove products.
  3. On the Approve products page, in the text box, enter an approval note, and then click Submit.
    After the background process is completed, the product is now available in the stage and with the status that you specify in your configuration settings.

Reviewing the selected products

Your selection of the target action for a product determines your review.

On the Review created products page, you can review all the information that is related to your target entity. Note any information that you want to add or modify and any items that you need to reconcile. You can make these changes in Configuring products in this section.

For updates to products, you can click the link for the target entity and review existing product metadata, cost shares, networks, benefits, and benefit categories for the updated versions. When you update a product, the new product receives merged information from both the parent product and the product template. In this case, you see the merged information.

No Warning icons are displayed next to your product Click Submit.
A Warning icon is displayed next to the product with information for your configurationHover over the icon, note the information, and then click Submit.
A Warning icon is displayed next to your product with an error message
  1. Hover over the Warning icon next to your product.
  2. Determine whether you want to withdraw or fix the error
  3. If you do not want to modify the product or you cannot fix the error, withdraw the Smart Update case:
    1. Click Actions Withdraw.
    2. If Withdraw is not an available action, on the Actions menu, click Review, and then click Actions again.

      Withdraw is now an available action.

  4. Based on the warning message, if you determine that you will fix the issue later, for example, adding data to the Market segment field, continue this Smart Update case and add the data during subsequent steps or later when convenient for you.
  5. If you want to correct the error in the straight-through processing flow, fix the issue, and then return to the Smart Update flow.
  6. To resolve other errors, repeat steps 1 through 4.
A Warning icon appears in the Manual review column of the item because you have items that have conflicts due to the merged data of the product and product template
  1. Hover over the icon to display the warning.
  2. Note the items that are indicated in the warning.

    During product configuration, you can make changes in any of the three tabs of metadata, benefit categories, and coverages information. For more information, see Configuring products in this section.

  3. Click Begin.

    The second review screen is displayed.

  4. Click Submit.

    Example: The following list shows items that you might need to reconcile. You can reconcile these items on the Configure Coverages page:

    • If a copayment for an existing product is not available (N/A) and the copayment for the new product is not available (N/A), but the product template has a range of copayments from $10 to $50
    • If a product shows not available for deductibles, but the product template has a range of values
    • If a product uses the embedded calculation type for deductible and out-of-pocket values and the product template uses the policy type calculation method
    • If a conflict exists between the coverage for a stand-alone benefit and the coverage for the same benefit within a grouper

Product extension rules

Rule nameClassDescription
ValidateSUProductAliasNameRule-HC-PCS-ProductUse this data transform rule to validate the AliasName of product if the alias name is already in system, for example if you want to restrict alias names across versions.
ValidateAndPopulateSUProductVersionRule-HC-PCS-ProductUse this data transform rule to extend the out-of-the-box versioning feature.
SyncPRDMetadataWithPTExtRule-HC-PCS-Product Use this data transform rule to copy the implementation-layer metadata attributes from the product template to the product.
ValidatePRDMetadataAfterSyncExRule-HC-PCS-Product Use this data transform rule to validate the implementation-layer metadata attributes that you copied from the product template to the product.
ConfigureProductsPostExtPegaPCS-HC-USA-Work-SmartUpdate Use this data transform rule to extend validations for changes to the product metadata, coverage, and benefit categories.
UpdateProductMetadataEXTRule-HC-PCS-Product Use this data transform rule to save the implementation-level metadata attributes that you added to all the products in the metadata batch.
InitializeCoveragePagesExt Rule-HC-PCS-UnionData Use this data transform rule to initialize any implementation-level coverage attributes in the union data class.
ConfigureCoveragesWrapperExt Rule-HC-PCS- Use this data transform rule to save the implementation-level coverage attributes that you added to all the products in the coverage batch.
UpdateBaseProductWithCloneProduct_EXT Rule-HC-PCS-Product When your target action is Update existing version, use this data transform rule to save the values (any implementation-layer properties) on the actual or base product.
SyncPlnMetadataWithPrdExtPegaPCS-Data-Plan If you changed product metadata, use this data transform rule to synchronize the metadata from the product to the plan. For example, previously, the product property was Individual and now you extend it to Individual and Commercial.
SetvaluesonPRDnodeUnionDataandBSTEXTRule-HC-PCS-ProductUse this data transform rule to synchronize coverages for the display on the product cost shares pages.
SetvalueswhenPRDandPThascoverageEXTRule-HC-PCS-NetworkUse this data transform rule to synchronize coverages or variations at the network-level union data when the source and target both have union data. If the target is plan, then the source is product. If the target is product, then the source is product template.
SetvalueswhenonlyPRDhascoverageExtRule-HC-PCS-NetworkUse this data transform rule to synchronize coverages or variations at the network-level union data when only the target has union data. If the target is plan, then the union data is present for the plan, but not for the product.
SetvalueswhenPRDandPThascoverageforBenorGrpEXTRule-HC-PCS-Use this data transform rule to synchronize coverages or variations at the benefit- or grouper-level union data when the source and target both have union data.

If the target is plan, then the source is product. If the target is product, the source is product template.

SetvalueswhenonlyPRDhascoverageEXTRule-HC-PCS-Use this data transform rule to synchronize coverages or variations at the benefit- or grouper-level union data when only the target has union data.

If the target is plan, then union data is present for the plan, but not for the product.

SetvalueswhenPRDandPThascoverageforGrpBenEXTRule-HC-PCS-BenefitUse this data transform rule to synchronize coverages or variations at the union data level of the benefit within the grouper when the source and target both have union data.

If the target is plan, then the source is product. If the target is product, the source is product template.

SetvalueswhenonlyPRDhascoverageGrpBenEXTRule-HC-PCS-BenefitUse this data transform rule to synchronize coverages or variations at the union data level of the benefit within the grouper when only the target has union data.

If the target is plan, then union data is present for the plan, but not for the product.

SyncPRDMetadataWithPTExtRule-HC-PCS-Product

Use this data transform rule to synchronize the product metadata with that of the product template.

Use this page information for the synchronization.

PTPage refers to the product template that is used in the smart update of the product.

pyDisplayHarness refers to the product page.

ValidatePRDMetadataAfterSyncExt

Rule-HC-PCS-Product

Use this data transform rule to add validation to the metadata properties after the product is synchronized.
SyncPlnMetadataWithPrdExtPegaPCS-Data-PlanUse this data transform rule to synchronize the plan metadata with that of the product.

Use this page information for the synchronization.

PTPage refers to the product that was used in the smart update of the plan.

PlanData refers to the Plan page.

ValidatePlanMetadataAfterSyncExtPegaPCS-Data-PlanUse this data transform rule to add validation to the metadata after the plan is synchronized.
ValidateInvalidBenefitCategoryContentExtPegaPCS-HC-USA-Work-SmartUpdateUse this data transform rule to add any validations to the benefit category.

BenCatBatchList is the page that holds the benefit categories.

SmartUpdateProductLevelCostsharesExtensionRule-HC-PCS-ProductUse this section rule to display any implementation-layer properties that were extended or initialized.
SUExtForNWCoveragesRule-HC-PCS-NetworkUse this section rule to extend any coverage configuration in networks for both products and plans.
SUExtRuleForBenOrGrpCoverageRule-HC-PCS-Use this section rule to extend any coverage configuration in the benefit, grouper, or benefit within grouper for both products and plans.
SmartUpdatePlanLevelCostsharesExtensionRule-HC-PCS-ProductUse this section rule to display any implementation-layer properties that were extended or initialized.
ConfigureCoveragesWrapperExtRule-HC-PCS-Use this data transform rule to save additional implementation-layer properties of coverages, variations, or additional details of the union data in products or plans.

Use the same wrapper for all levels of union data, for example, benefit or network.

The following includes the parameters and page information:

  • The CoveragePageRef page holds the coverage values that are configured in the user interface.
  • The context is the UnionDate rule page.
  • The EntityType parameter holds the node type, for example product, plan, network, and benefit or grouper.
  • The CoverageUpdateType parameter holds the type of coverage action, for example, UpdateCoverage, No Action, or Restore Inheritance.
UpdateInheritanceForUnionData_EXTRule-HC-PCS-Use this data transform rule to check if the cost share is overridden. If it is overridden, then set the InheritanceParentLegend for that cost share to Param.ParentLegend
SetInheritanceParentsInProductSmartUpdate_EXTRule-HC-PCS-Use this data transform rule to identify and set the inheritance based on the product configuration.

Use the ParentRef parameter page to refer to the parent node.

If the cost share can be inherited from the parent, then use the ParentRef page as the source to populate Inheritanceparent, if the cost share is not already overridden at that level.

SetInheritanceParentsInPlanSmartUpdate_EXTRule-HC-PCS-Use this data transform rule to identify and set the inheritance based on the plan and product configuration.

The OrgProductRef parameter page refers to the corresponding product.

On the OrgProductRef page, check for the inheritance flag of the extended properties. Based on the property that was set, the corresponding inheritance legends are updated on the tree.

SUCoverageExtForProductRule-HC-PCS-ProductUse this data transform rule to extend the product-level coverages by initializing the coverage page so that the initialized coverages display on the page.

All the initialized pages will be in the ProductData page.

SUCoverageEXTForNWBenGrpBenInGrpRule-HC-PCS-Network

Use this data transform rule to extend network, benefit, grouper, or benefit within a grouper by initializing the coverage page so that the initialized coverages display on the page.

This initialized page, will be available on the TargetNetworkList page.

For example, if you want to extend the Costshares pagelist, then add cost shares (9) directly to the Costshares pagelist of the TargetNetworkList.

SmartUpdatePlanCoverageExtensionRule-HC-PCS-Product

Use this data transform rule to extend plan level coverages by initializing the coverage page so that it displays on the page (just for the plan section).

All the initialized pages will be in the ProductPlanData page.

SUPlanCoverageEXTForNWBenGrpBenInGrpRule-HC-PCS-Network

Use this data transform rule to extend network, benefit, grouper, or benefit within grouper-level coverages by initializing the coverage page so that the initialized coverages display on the page.

This initialized page, will be available on the TargetNetworkList page.

For example, if you want to extend the Costshares pagelist, then add cost shares (9) directly to the Costshares pagelist of the TargetNetworkList.

Tags

Pega Product Composer for Healthcare 8.5

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