Benefit determination is an automated process that is executed by Smart Claims Engine in the benefit determination module (CE_DetermineBenefit), one of several sequence modules required to support the application’s adjudication process.
To configure the benefit determination module.
- Select the Designer Studio > Claims Engine > Claims Engine
Configuration landing page.
All processing modules are displayed on the Claims Engine Configuration landing page.
- Click the CE_DetermineBenefits hyperlink.