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Updated on October 9, 2020

The Claims Engine Configuration landing page provides configuration settings that define how the Pega Smart Claims Engine for Healthcare processes a claim. These settings are stored in the Rule-HC-CE-Configuration rule that populates the Declare_Config data page on the clipboard. Components in Pega Smart Claims Engine for Healthcare can access and leverage these settings to affect processing.

You can access the Claims Engine Configuration page from Designer Studio, by clicking on the Configure tab, then Claims Engine > Claims Engine Configuration.

The Claims Engine Configuration landing page has three tabs:

  • Application Configuration
  • Module Configuration
  • Claim Edits

You need to complete the configuration before you can adjudicate claims. Click Save Configuration to save any changes:

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