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Configuring exceptions ranking and claim disposition

Updated on May 20, 2022

The AddClaimExceptionsdata transform rule adds all the exceptions that are flagged in the validation process to the claim unit.

The RankExceptionsdata transform rule ranks the claim exceptions and sets the claim disposition with the disposition value that is defined for the highest ranked exception.

Use the ExceptionsRanking decision table to rank the exceptions. Ranking is initially done based on the ClaimDisposition that is defined for the exception in the ExceptionCodesMapping decision table. Later, it checks for the ExceptionCode and redefines the ranking. The values for the ExceptionCode and ClaimDisposition should be defined strictly according to values defined in the ExceptionCodesMapping decision table.

  1. In the navigation panel of Dev Studio, click Records.
  2. Click Decision > Decision Table.
  3. Click the filter for Purpose and search for ExceptionsRanking.
  4. Click the corresponding rule to open it.
  5. Configure as needed and save the rule into your implementation layer. For additional information about locked and unlocked rulesets, see Copying a rule or data instance.
  6. Click Save.

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