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Claims – PUT (update) claim

Updated on April 26, 2021

PUT claim service rule takes claim JSON as parameter and finds the claim with the Claim ID passed in the JSON. If found, updates with input JSON, adjudicates and then returns the Claim ID in JSON format.

URL format
PUT https://[hostname:port]/prweb/PRRestService/healthcareapi/v1/Claims


"Claim ID": "2017299P0000006000",

"methodStatus": "Good"


Key rules
Rule nameRule typeUsage
Class: PegaHC-Int-Claims
PutClaimAPIService activityMethod in REST service to update claim and adjudicate and then return claim ID as response.
ClaimsService RESTREST service rule that identifies the path, parameters, and methods
MapToEntityWrapperData TransformWrapper DT which calls “MapToEntity” and can be extended for Extension.
MapToEntityData TransformMaps the JSON properties to Claim.
PutClaimAPI_ExtensionActivityTries to identify the Claim in the system with the given ClaimID in the JSON; then maps claim JSON to PegaClaim work object, merges the incoming claim with the identified claim in the system and calls CE_Main_2 work flow to adjudicate the claim as per the orchestration id mentioned in the JSON and returns Claim ID of the adjudicated claim.

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