- Open dynamic system settings: EnableQPForClaimProcessing.
- By default the value for the queue processor is set as “False”. The claims are processed using the job scheduler for this setting. You can change the value of the DSS to “True” to enable the queue processor. Queue processor processes claims whenever queue item is available.
- Once the ‘True’ value is saved, the claims are processed through queue processor. In this case, the claim processing settings such as manual process buttons for new and reprocess claims in the ‘Claims engine configuration’ screen are not displayed, as the claims are automatically processed through QP. Only “Process Now” button for recycle claims is displayed.
- Split and pending reprocess claims are also being processed through the same queue processor.
- You can also prioritize claims for WO adjudication queue processor based on selected
payer ID values which are coming from OOTB. This decision table can be extended
further to include any other properties from claim WO class. To do so custom queue
processor has to be created and claims have to queued to the custom queue processor
using the extension rule: QueueClaimForAdjudicationEXT.
- The queue processor: ProcessPriorityClaim is enabled from Admin studio.
- Values for payer identification number and corresponding return action are entered in the DT: PrioritizeClaimProcessing. The payer IDs for which claims need to be processed on priority are entered in the ‘Payer identification number’ columns while the queue processor ID for priority claims: ProcessPriorityClaim is entered in the ‘Action’ column.
- On saving, the claims for the configured payer IDs are processed on priority through the priority queue processor.
Advantages of using the queue processor include:
- Vertical and horizontal scaling.
- Platform OOTB recovery and exception infrastructure.
- Prioritization of claim with new implementation design.