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Extending processing

Suggest edit Updated on September 18, 2020

Copy the following rules in your ruleset to extend the claim lookup and processing:

NameTypeDescription
OpenClaimActivitySearches for claim by submitted Payer Claim Control Number.
SetValueForCreateClaimRequestActivityMaps claim information from matched claim.
SetClaimValuesActivitySets information is matching claim is not found.

For additional information, refer to the Healthcare X12 EDI Message Management Technical Specifications on the Pega Foundation for Healthcare product page.

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