Loading and extending reusable entities in PCS

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Loading and extending reusable entities in PCS

Description Design inputs to consider while loading and extending the reusable entities in PCS
Version as of 8.5
Application Pega Product Composer for Healthcare
Capability/Industry Area Healthcare and Life Sciences



Loading and extending reusable entities in PCS

PCS application has layers of reusable entities that come together to form complex health plans.

You may need to add large number of entities into PCS - for example when starting to adopt PCS, or when extending PCS into a new line of business, or when you want to set up a new test system. To make the data entry fast and convenient, PCS application provides the PCS import feature.

With PCS import feature, you can import data for each of the following reusable entities: benefit, grouper, benefit set, network and benefit categories. With this feature, you define the required data in a Microsoft Excel template that is included in the application and simply import the excel into PCS. Standard Pega cases would be created by the application, for each successful record imported into PCS.

Use case examples

All PCS entities have metadata information, that uniquely identify the respective entity. Often times, the client wants to add additional properties and enhance the current metadata for PCS entities. For example, a client may want to add the following properties - Is Preventive care benefit, or Is Mandated benefit. These new properties will allow processing of the benefits when they are part of the health plans and also allow implementation teams to enforce validation rules on the plans.

The client team wants these two new properties to appear on the UI, and also use PCS import feature to bring those along with the rest of the benefit information directly into PCS via excel. This would require us to update the out of the box PCS import feature.

Extending the reusable entities

There are two steps to achieve this

  1. Update the UI to add additional properties
  2. Update the PCS import feature to reflect these new properties

PCS application provides the respective excel templates for each entity. For example if the user wants to import benefits, they can start by downloading the Benefits template from Process Entities --> Import --> Run PCS Import --> select benefits in the dropdown.

PCS Import - Benefit template

More information about the process can be found here

Results

The built in automation that PCS import feature provides should be leveraged and business teams should be made aware of this during the start of the project. With this knowledge about the role of PCS import feature and the process to extend it for various scenarios, you can quickly hit the ground running with PCS adoption or expansion phases.