Subscriber/Patient data masking functionality can be defined as functionality within the claim system where Subscriber/patient’s PII (Personally Identifiable Information) is masked, based on Subscriber/Patient VIP/Employee status in the system. PII will be masked on claims and other data model UI for employees or VIPs for unauthorized users. However, users with appropriate roles can access PII data.

The fields that are masked are controlled by the Pega Foundation for Healthcare field attributes that identify whether a subscriber/patient is and employee or VIP member. If a claim for a VIP or Employee is presented for resolution, and the user does not have the required role, then the fields will be masked.

This section shows how the masking made and the associated Rules.

• Business user information

• Core Configuration