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Extending the Pega Product Composer for Healthcare application

Updated on January 26, 2021

Based on your organization's needs, you can extend application-provided features such as metadata, entity keys, networks, and benefit mapping. You can also extend data validation activity rules and union data.

Pega Product Composer for Healthcare Pega Product Composer for Healthcare Pega Product Composer for Healthcare Pega Product Composer for Healthcare Pega Product Composer for Healthcare Pega Product Composer for Healthcare Pega Product Composer for Healthcare Pega Product Composer for Healthcare

Configuring benefit mapping

A benefit, the basic building block in Pega Product Composer for Healthcare, is made up of benefit definition options. You can dynamically configure additional benefit definition options and configure the code groups needed for the benefit mapping definition.

For example, you can add more service groups or places of service to your benefit.
  1. In the header of Dev Studio, click ConfigureProduct composer systemConfiguration.
  2. Click the Flow settings tab.
  3. In the Benefit mapping section, click the Add a row icon to add a new benefit definition option.
  4. Enter the information in the fields, and then select from the lists.
  5. When you are finished, click ActionsSave as system configuration.
    Result: The changes to the benefit mapping apply to new benefits. The changes do not apply to existing benefits in the system.

Extending entity metadata

You can easily extend Pega Product Composer for Healthcare entity attributes or metadata. For example, you can add or remove a line of business.

The following list shows the metadata fields that you can extend and the name of the corresponding class:

  • Line of business (PegaHC-Data-LineOfBusiness)
  • Market segment (PegaHC-Data-MarketSegment)
  • Coverage level (PegaHC-Data-BenefitCoverageLevel)
  • Product line (PegaHC-Data-PlanType)
  • Exchange level (PegaHC-Data-PlanExchangeLevel)
  1. In the navigation panel of Dev Studio, click Data types and then in the search field, enter and search for the class name from the list above that corresponds to the item that you want to extend.
  2. On the Data Type page, click the Records tab.
  3. Click the Add record icon.
  4. In the field that corresponds to the name of the class that you are extending, enter a name for display.
    For example: You might enter Mental Health as a new line of business.
  5. Save your changes.
  6. Repeat these steps for each metadata field that you want to extend.

Changing the key of an entity

Sometimes, you must change a key of a Pega Product Composer for Healthcare class to meet the business need of a client. For example, you might want multiple instances of the same product in different lines of business. In this case, you cannot use the Pega-provided keys. You must change the key that represents the line of business.

Before you begin: You can only make this change when the class is empty. There cannot be any entities in the class.
  1. In the navigation panel of Dev Studio, click App and then enter the name of a class at the top of the navigation panel.
    For example: Enter PegaPCS-Data-Plan.
  2. Click SysAdmin, and then click Class.
  3. Click the class, for example, PegaPCS-Data-Plan.
    Result: The General tab displays the ContractID key.
  4. Modify the key as necessary and click Save.

Extending a network

Because much of the provider network information is stored in third-party systems, client teams configure new networks when needed or extend existing ones to drive the sales and servicing of their plans. Then they associate the networks with the plans.

In Pega Product Composer for Healthcare, you can extend a network to add properties or rules, based on the client needs. For example, you want to add a property to a section of a network.
  1. In the navigation panel of Dev Studio, click AppAcceleratorNetworkUser Interface.
  2. Click Section, and then click the section where you want to add details.
  3. When you are finished, click Save as and select an option.

Extending data validation activity rules for PCS Import

Use the listed extension activity rules in the table below to add validation fields that you need for the PCS Import flows. The main activity rule calls the extension activity rule at run time. For additional information about activities, see Activities.

  1. In the header of Dev Studio, enter the name of the extension activity rule that is listed in the table in the search field.
  2. Click the name of the activity.
  3. Check out the rule and save it.
  4. On the extension page, add the fields for validation.
    For additional information, see Activities.
  5. Save your changes and check in the rule.
    Extension activity rule Call from this activity rule Description
    ValidatePrimaryExcelFieldsEXTValidatePrimaryExcelFieldUse this activity rule to validate the main properties that are required for the PCS import flows.
    ValidateDatesAndStatusEXTValidateDatesAndStatusUse this activity rule to validate the overlapping dates of the consumed entities, for example, a benefit being added to a benefit set. If there is not at least one day overlapping between the benefit and the benefit set, a validation error occurs and the benefit is not accepted. This activity rule also checks for rejected or retired statuses of entities.
    ConvertingDatesForPolicyTermEXTConvertingDatesForPolicyTermUse this activity rule to validate the dates that you entered for policy terms in the PCS import flows.
    GroupPolicyListEXTGroupPolicyListUse this activity rule to group all the rows that are related to one policy into a single list.
    BenefitDataLoadValidationsWrapperEXTBenefitDataLoadValidationsWrapperUse this activity rule to validate all the business functionality that is related to the PCS import flows for benefits and call all post-activities from the main flows.
    AutoDataLoadGrpValidationEXTAutoDataLoadGrpValidationUse this activity rule to validate all the business functionality that is related to the PCS import flows for groupers and call all post-activities from the main flows.
    ADLBenefitSetValidationWrapperEXTADLBenefitSetValidationWrapperUse this activity rule to validate all the business functionality that is related to the PCS import flows for benefit sets and call all post-activities from the main flows.
    NetworkValidationsWrapperEXTNetworkValidationsWrapperUse this activity rule to validate all business functionality related to the PCS import flows for networks and call all post-activities from the main flows.
    PolicyTermsValidationsWrapperEXTPolicyTermsValidationsWrapperUse this activity rule to validate all the business functionality that is related to the PCS import flows for policy terms and call all post-activities from the main flows.

Adding new properties to entities

In Pega Product Composer for Healthcare, you might want to add other fields that describe basic information to entities to meet your business needs. For example, you can add the Purpose for creation field to the benefit entity to provide more information about why you are configuring the benefit.

Before you begin: Before you can add fields to the pages of entities, you need to create the properties that correspond to the new fields. For additional information, see Properties.
Use this table to find the information that you need to complete the steps in the following task.
EntityClassSection
Benefit Rule-HC-PCS-BenefitBenefitClientConfiguration
Policy TermRule-HC-TermPolicyTClientConfiguration
PolicyRule-HC-PolicyPolicyClientConfiguration
GrouperRule-HC-PCS-GrouperGrouperClientConfiguration
Benefit setRule-HC-PCS-BenefitSetBenefitSetClientConfiguration
NetworkRule-HC-PCS-NetworkNetworkClientConfiguration
Product templateRule-HC-PCS-ProductTProductClientConfiguration
ProductRule-HC-PCS-ProductPProductClientConfiguration
PlanPegaPCS-Data-PlanContractClientConfiguration
Plan bundlePegaPCS-Data-BundleBundleClientConfiguration
  1. In the navigation panel of Dev Studio, click App and enter the name of the class that corresponds to the entity that you are modifying in the search field.
  2. Click User InterfaceSection and select the section that corresponds to the entity that you are modifying.
  3. Click Save as to save the section rule to the implementation ruleset.
  4. Click Client Configuration to expand the section.
  5. Drag the property into the section.
  6. Repeat these steps to add new fields to other entities.
Result: You can view the new fields on the first page of an entity in the Client configuration section of the Product Development portal.

Extending user-defined fields

Pega Product Composer for Healthcare provides some fields, called user-defined fields, where you can customize the values for the options.

Before you begin: To enable these fields, select the Enable legacy properties check box on the Product composer system configuration page. For additional information, see .
For example, you can define list options for fields, such as Termination reason, Legal entity, and Jurisdiction to meet your business needs.
  1. In the header of Dev Studio, click Launch portalProduct Development.
  2. In Pega Product Composer for Healthcare, in the Enter details step of the wizard for plan, product, or product template, select the field, for example, Termination reason and click the Open runtime toolbar in the bottom right corner.
  3. Click the Toggle Live UI icon
  4. Select the field for which you are configuring options.
  5. Click the View properties icon at the right of the field.
  6. In the Cell Properties dialog box, at the right of the Property field, click the Open section icon.
  7. Check out the rule. For more information about checking out a rule, see Checking out a rule.
  8. On the Property page, scroll to the Prompt values section.
  9. In the Standard value field, enter text that suits your business, for example, T1-Termination.
  10. In the Prompt value field, enter text, such as Obsolete Product.
  11. Click Save.

  • Previous topic Extracting Pega Product Composer for Healthcare data and generating reports
  • Next topic Extending union data

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