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Exchanging data with external systems

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Updated on August 31, 2021

As a repository for accumulators and associated transaction history, the accumulator manager depends on integrating with external applications to receive and send benefit usage information. This integration is accomplished using several Automated Program Interfaces (APIs), which enable the performance of the accumulator manager’s key functions.

There are four APIs associated with the Accumulator Manager:

  • These two APIs are used to perform queries into accumulator information at the header- and transactional-detail levels:
    • Accumulator Inquiry
    • Detail Inquiry
  • These two APIs are used to enable the retrieval and update of accumulators during the adjudication process:
    • Retrieve for Update
    • Update
Inquiry API

The Inquiry API enables the retrieval of accumulator header- and transactional-detail information from the accumulator manager by an external system, such as a customer service help desk or self-serve portal.

It ascertains the current status of existing accumulators and their associated detail. The Inquiry API supports inquiries for single or multiple accumulators. It responds with a list of accumulators and, if selected, a list of all transactions associated with each accumulator. This API facilitates the transmission of inquiry (Send) parameters from the external system to the accumulator manager, and the automated retrieval (Inquiry Response) of accumulators and their associated detail according to the user-defined parameters.

Detail inquiry API

The Detail Inquiry API enables you to retrieve all the individual transactions associated with a selected single accumulator.

Retrieve for update API

During the auto-adjudication process, prior to performing the calculations required to update the accumulators, the application needs to retrieve the existing accumulators that are associated with the claim being processed. The Retrieve for Update API retrieves the accumulator information according to the matched benefit properties on the claim. You can select multiple accumulators in the Retrieve for Update API.

Update API

Upon completion of the calculations required for updating accumulators, the application posts the updates to the accumulator manager using the Update API. In addition, the Update API lets you create new accumulators in the event that no matching accumulators were returned during the Retrieve for Update API. The Update API enables the application to post new transaction data to the accumulator, which is then stored in the accumulator manager. Once the new transaction data has been posted to the accumulator, the accumulator manager sends a message to the application indicating that the posting of new transaction data on the accumulator was successful or unsuccessful.

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