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On-Us business routing decision

Updated on June 21, 2022

The On-Us business routing decision includes business rules driven for claims and disputes for American Express, VISA, and Mastercard.

Pega Foundation for Healthcare

A transaction is identified as On-Us when the transaction type with the ARN BIN matches the BIN in the system. Based on this evaluation at the case creation level, the flag On-Us Transaction is set to true.

Once the transaction is marked On-Us with the given business rules, it is further evaluated at the Qualify Dispute stage to check if the transaction is On-Us eligible. If the transaction meets the business evaluation, the flag On-Us Transaction Eligibility is set to true.

In the case of the Dispute Multiple Transactions (DMT) process (bulk processing, which includes all the disputes as part of a claim), each transaction is evaluated and if at least one case is set to On-Us Transaction Eligibility false, then all the transactions and the claim are marked as On-Us Transaction Eligibility false.

The EvaluateOnUs decision table in the VISA, American Express, and Mastercard classes is configured with the following fields by default:

  • Dispute Amount - Range of valid dispute amount
  • Reason Code - Value selected in the Qualify Dispute stage

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