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Step 7: Defining integration

Suggest edit Updated on April 23, 2021

You must inventory which external applications exist at your site and plan how to connect to them. Some common integration points for the Pega Foundation for Healthcare include interfaces to:

  • Membership and enrollment systems of record
  • Plan benefit and eligibility management systems
  • Practitioner and provider system of records
  • Provider networks and contracting systems
  • Medical (utilization) management systems
  • Claims system
  • X12 EDI gateways/source systems

Note: Identify integration points as early in your planning as possible. If a connection to an external data source is required and either the data itself does not exist or the interface to that data does not exist, you must account for the time to build the interface to this application.

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