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CXT Response to SCE Event Code & Action Code Mapping

Updated on October 9, 2020

As mentioned previously, SCE sends the required claim data to ClaimsXten. ClaimsXten returns a recommendation for each line. Recommendations are add, deny, support, and pay percent. SCE has the capability to raise an event code and/or action code for each recommendation type. Based on the event code raised, SCE would suspend or deny the claim. The system also checks for action codes associated to the claim.

The CXTResponseToSCECodes table looks at the form type, rule acronym, certainty, case action, rule type, claim line action, customer adjustment code and audit type on the response and maps it to an appropriate event code and/or action code.

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