Orchestration
In Pega Smart Claims Engine for Healthcare, the claims engine adjudication code is packaged as modules. The Orchestration structure allows inclusion of configurable Initialization and Finalization rules (likely collection rules with extension points) as well as Module Sequences instead of the Modules themselves. The Orchestration gives the capability to be run from start to finish but when claim conditions are recognized, the Orchestration can be stopped at any point (particularly Event Processing) to route the work to an appropriate user/workbasket.
The Orchestration level is a wrapper definition of the start to finish process. Each Orchestration is made up of one or more Module Sequences. Each Module Sequence is a new structure that the user can add/maintain. Module Sequences contain a sequenced list of Modules and can be reused across multiple Orchestrations. The Module Sequence may be stopped at any point (particularly Event Processing) to route the work to an appropriate user/workbasket. Module Sequences produces a result status that is used to determine whether to continue to the next Module Sequence, restart the sequence, restart the Orchestration or stop processing. The Sequence is run in the order defined during adjudication.
The below diagram depicts the hierarchy how modules are included in a sequence and subsequently a sequence is included in an orchestration.
Previous topic Manipulating the orchestrations Next topic Claim edits tab