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Rational for implementing De-batch logic in SCE

Updated on April 26, 2021

Pega Smart Claims Engine for Healthcare has the capability to parse different file types, such as EDI, XML, API and ITS. However, earlier versions of Pega Smart Claims Engine for Healthcare supported the submission of only one claim in a single EDI file. In addition, the user could only select limited delimiters within the EDI file. As this is not aligned with industry standards, enhancement of de-batching logic was required. Consequently, current logic allows (a) selection of files having multiple claims, and (b) consideration of multiple acceptable delimiters.

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