This chapter explains how a user of Pega Smart Claims Engine for Healthcare can leverage the Pega Healthcare API. Pega Healthcare API enables you to leverage built-in REST/JSON services to integrate your Pega applications with external systems to request, receive, and send data. You can call any of the Pega Healthcare API services by using standard HTTP methods (for example: GET, POST, or PUT). The supported APIs provide a standard set of services and request include access to data pages for commonly referenced objects in healthcare applications, for example, Member, Provider, Claim, and so on. These APIs enable rapid deployment of your Pega’s healthcare applications.

• Service package rule
• Dynamic settings end point URL management data page
• Claims - Post claim (outbound to Smart Claims Engine)
• Business service APIs
• Integrating with external data
• Integrating with REST APIs