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Smart Claims Engine and NetworX Pricer integration

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Updated on August 31, 2021

Through the integration of NetworX Pricer® (NetworX) with Smart Claims Engine, data is passed back and forth between the two systems during claims processing. The SCE orchestration layer interfaces with NetworX as a stand-alone rule set that is executed in a discrete adjudication sequence module.

During processing, SCE identifies those claims that meet the criteria for NetworX pricing, prepares the identified claims for pricing, and submits the required data (i.e., claim data and rate sheet information) to the NetworX Pricer® application using an Application Programming Interface (API).

NetworX returns the pricing information back to the SCE, where the data is used to update the claim work object prior to the execution of subsequent processing sequence modules.

The module SANP pricing (SSP) is provided to support NetworX pricing.

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