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Field level security

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Updated on August 31, 2021

Within Smart Claims Engine, the Claims Examiner (or any configured role) is given the opportunity to correct or adjust the Claim using the actions button on the screen. The field level security allows the configuration of the available fields which could be used in the UI for corrections and adjustments. The configurations are applied based on the access group of the operator. The two actions available for access specific field security are Adjustment and Update claim data. If the field is available for editing, then the field would be presented to the user in an editable control. If the field is not available for editing, it would be presented in a read-only control.

Configuration

There are two tables that control the field level security. Both tables have the same structure. If a field is not listed on the table, then it will not be editable. Out of the box, the SCE provides all the key fields on the claim in the decision table:

ColumnDescription
User access group

Enter the access group for the security if required. If nothing is entered, then no field level security is applied.

Examples:

“PegaClaims:Administrator”

“SCEExtension:ClaimsExaminer”

Claims status

Status of the claim if required. This allows different statuses of the claim to have different field available for correction or adjustment.

Examples:

“Pending-Investigation”

“Resolved-Paid”

“Pending-Approved”

Editable properties

Full reference of the label of field on UX requiring field level security.

Examples:

“Claim.Patient.PolicyNumber”

“Claim.COB().Payment.PaidDate”

“Claim.ClaimLine().Payment.LineItemChargeAmount”

  • The decision table for configuring fields for adjustment is: ClaimManualEditsConfiguration
  • The decision table for configuring fields for claims correction / update claims data is: ClaimManualEditsConfigurationClaimUpdate
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