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Mapping claims objects

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Updated on August 31, 2021

NetworX completes its price calculations and returns the pricing data back to the SCE where the claim work object is updated, and the information is displayed on the claim user interface.

The NetworX pricing XML response file includes values associated with a number of pricing properties at the claim header and claim line level for both professional and institutional claims. The application maps each claim line level property exactly as it is returned in the response file, without further calculation. However, the value of certain claim header level pricing properties (e.g., Billed amount, Allowed amount, Savings) are calculated values representing the sum of their corresponding claim line-level values. In addition, all pricing detail properties at the claim header and claim line level are mapped to the SCE work object exactly as returned in the NetworX XML response file.

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