Pega Smart Claims Engine for Healthcare preconfigured data pages
Pega Smart Claims Engine for Healthcare contains the following preconfigured data pages, which you can use according to your business needs.
| Data Page | Class | Structure | Use or Parameters |
|---|---|---|---|
| D_CE_BillingProviderList | PegaHC-Data-Party-BusinessEntity | Page-list | List of available Business Entities |
| D_CE_BusinessEntity | PegaHC-Data-Party-BusinessEntity | Page | Business Entity ID, Effective Date |
| D_CE_COB_Contract | PegaHC-Data-Contract | Page | Contract ID |
| D_CE_COB_Payer | PegaHC-Data-Party-Payer | Page | Payer ID |
| D_CE_COB_PayerByContract | PegaHC-Data-Party-Payer | Page | Payer ID |
| D_CE_COB_Policy | PegaHC-Data-Policy | Page | Policy ID |
| D_CE_COB_Subscriber | PegaHC-Data-Party-Member | Page | Last Name, First Name, DOB |
| D_CE_COBPayerbyContract | PegaHC-Data-Party-Payer | Page | Payer ID |
| D_CE_Contract | PegaHC-Data-Contract | Page | Contract ID |
| D_CE_ContractbyPolicy | PegaHC-Data-Contract | Page-list | Contract ID |
| D_CE_ContractsByPatient | PegaHC-Data-Party-Member | Page-list | Patient ID |
| D_CE_FetchBusiEntitiesByAddress | PegaHC-Data-Party-BusinessEntity | Page | Retrieve Business Entities by using string of values for Query |
| D_CE_FetchBusinessEntities | PegaHC-Int-ElasticSearch-Response | Page | Retrieve Business Entities by using string of values for Query |
| D_CE_GetAllProviderList | PegaHC-Data-Party-BusinessEntity | Page-list | Retrieve Business Entities by using string of values for Query |
| D_CE_MemberList | PegaHC-Data-Party-Member | Page-list | Effective Date |
| D_CE_Network | PegaHC-Data-Network | Page | Network ID, Effective Date |
| D_CE_OtherSubscriber | PegaHC-Data-Party-Member | Page | Subscriber ID |
| D_CE_Patient | PegaHC-Data-Party-Member | Page | Patient Last Name, First Name, DOB, Policy Number |
| D_CE_PatientByID | PegaHC-Data-Party-Member | Page | Patient ID |
| D_CE_PatientByOther | PegaHC-Data-Party-Member | Page-list | Patient Last Name, First Name, DOB |
| D_CE_PatientHistoryDetails | PegaHC-Int-ElasticSearch-Response | Page | Retrieve Patient History Details using string of values for Query |
| D_CE_Payer | PegaHC-Data-Party-Payer | Page | Payer ID |
| D_CE_PayerbyContract | PegaHC-Data-Party-Payer | Page | Payer ID |
| D_CE_PlanDetails | PegaHC-Data-Plan | Page | Plan ID |
| D_CE_Policy | PegaHC-Data-Policy | Page | Policy ID |
| D_CE_PolicyByID | PegaHC-Data-Policy | Page | Policy ID |
| D_CE_PolicyBySubscriberNumber | PegaHC-Data-Policy | Page-list | Subscriber Number, Policy ID |
| D_CE_PPEMUE | PegaHC-Data-PPEMUE | Page-list | Procedure Code |
| D_CE_ProviderContract | PegaHC-Data-ProviderContract | Page | Contract ID, Effective Date |
| D_CE_ProviderList | PegaHC-Data-Party-Provider | Page-list | Gets all providers |
| D_CE_RateSheet | PegaHC-Data-RateSheet | Page | Rate Sheet ID, Effective Date |
| D_CE_RateSheetIDTS | PegaHC-Data-RateSheet | Page | Res Sheet ID |
| D_CE_Subscriber | PegaHC-Data-Party-Member | Page | Populated from either of the following: |
| D_CE_SubscriberByID | PegaHC-Data-Party-Member | Page | Subscriber ID |
| D_CE_SubscriberByOther | PegaHC-Data-Party-Member | Page-list | First Name, Last Name, DOB |
| D_CE_SubscriberByProfileKey | PegaHC-Data-Policy | Page-list | Subscriber ID |
| D_CE_SubscriberLockList | PegaHC-Data-SubscriberLock | Page-list | Subscriber ID |
| D_CE_SupervisingNPI | PegaHC-Data-Party-Provider | Page-list | PI |