Difference between revisions of "Extending portals to enhance the claims processing experience"

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{{Design pattern|Title=Extending portals to enhance the claims processing experience|Description=Concepts and considerations for extending claim processing portals.|Version=8.5|Applications=Pega Smart Claims Engine for Healthcare|Capability Area=Healthcare and Life Sciences|Owner=Touck}}
|Request to Publish=Yes
 
|Curator Assigned=szall
 
|Description=Concepts and considerations for extending claim processing portals.
 
|Applications=Smart Claims Engine
 
|Capability Area=Healthcare
 
|Version=8.5
 
}}
 
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== Definition and concept ==
 
== Definition and concept ==
SCE Portals are interfaces supplied with the application. The include common roles associated with claims processing systems. Common examples are business analyst, claims examiner, claims manager, and system manager. Review the SCE user guide for a more complete listing of portals and available features of each.
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Pega Smart Claims Engine (SCE) for Healthcare portals are interfaces supplied with the application. They include common roles associated with claims processing systems. Common examples are business analyst, claims examiner, claims manager, and system manager. For a complete listing of portals and their available features, see [https://community.pega.com/knowledgebase/documents/pega-smart-claims-engine-healthcare-85-user-guide Pega Smart Claims Engine for Healthcare User Guide].
  
Each portal provides access to features supporting the role common to processing systems. There is overlap between features, menu items, and functionality between portals. Careful consideration is given to features available in each portal but there they may not cover all business needs. Content can be customized to display any data integrated into the application. SCE portals come with extension points to support custom user interface requirements.  
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Each portal provides access to features supporting the role common to processing systems. There is overlap between features, menu items, and functionality between portals. Careful consideration is given to features available in each portal to cover many business needs. You can customize content to display any data integrated into the application. SCE portals come with extension points to support custom user interface requirements.  
  
 
== Key considerations ==
 
== Key considerations ==
Always use predefined extension points when available. This reduces impact during upgrade.  
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When you extend SCE portals, apply the following guidelines:
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* Always use predefined extension points when available. This reduces impact during upgrade.
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* Use the screen space to maximum effect by focusing on the information required to complete the task at hand. Too much information may slow the screen performance or overwhelm the end user. Too little information will require the user to look to external sources slowing productivity.
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* Review content of the included portals as a starting point. Sections can be added but the recommended approach is to update the extension sections with additional properties. 
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* Extension points for specific interface screens can be found by browsing the live UI. For additional instructions, see [https://community.pega.com/knowledgebase/articles/pega-smart-claims-engine-healthcare-implementation-guide/85/pega-smart-claims-engine-healthcare-implementation-guide Pega Smart Claims Engine for Healthcare Implementation Guide].
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[[File:Portal UI Image.png|none|thumb]]
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* Rules overridden in the implementation layer will take precedent over updated product rules. Review release notes to identify when new enhancements can be used instead of a custom code.  
  
Use the screen space to maximum effect by focusing on the information required to complete the task at hand. Too much information may slow the screen performance or overwhelm the end user. Too little information will require the user look to external sources slowing productivity.
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== Use case examples ==
 
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The following figures show examples of how you can extend SCE portals:
Review content of the included portals as a starting point. Sections can be added but the recommended approach is to update the extension sections with additional properties. 
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[[File:Member info extension.jpg|none|thumb|1397x1397px|Adding member information on the main claim display]]
  
Extension points for specific interface screens can be found by browsing the live UI. Review the implementation guide for additional instructions.  
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[[File:Provider credentialing extension.jpg|none|thumb|1416x1416px|Adding credentialing data]]
[[File:Portal UI Image.png|none|thumb]]
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Rules overridden in the implementation layer will take precedent over updated product rules. Review release notes to identify when new enhancements can be used in lieu of carrying forward custom code.
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[[File:Financial information extension.jpg|none|thumb|1384x1384px|Adding financial data]]
  
== Use case examples ==
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== References ==
Adding member info on the main claim display:
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[https://community.pega.com/knowledgebase/articles/pega-smart-claims-engine-healthcare-implementation-guide/85/pega-smart-claims-engine-healthcare-implementation-guide Pega Smart Claims Engine for Healthcare Implementation Guide]
[[File:Member info extension.jpg|none|thumb|1397x1397px]]
 
Adding credentialing data:
 
[[File:Provider credentialing extension.jpg|none|thumb|1416x1416px]]
 
Supporting financial data:
 
[[File:Financial information extension.jpg|none|thumb|1384x1384px]]
 
  
== Reference materials on Community ==
 
 
[https://community.pega.com/knowledgebase/articles/pega-smart-claims-engine-healthcare-implementation-guide/85/extending-your-application Extending the application]  
 
[https://community.pega.com/knowledgebase/articles/pega-smart-claims-engine-healthcare-implementation-guide/85/extending-your-application Extending the application]  
  
 
[https://community.pega.com/knowledgebase/documents/pega-smart-claims-engine-healthcare-85-user-guide SCE user guide]
 
[https://community.pega.com/knowledgebase/documents/pega-smart-claims-engine-healthcare-85-user-guide SCE user guide]

Latest revision as of 20:37, 7 June 2021

Extending portals to enhance the claims processing experience

Description Concepts and considerations for extending claim processing portals.
Version as of 8.5
Application Pega Smart Claims Engine for Healthcare
Capability/Industry Area Healthcare and Life Sciences



Definition and concept[edit]

Pega Smart Claims Engine (SCE) for Healthcare portals are interfaces supplied with the application. They include common roles associated with claims processing systems. Common examples are business analyst, claims examiner, claims manager, and system manager. For a complete listing of portals and their available features, see Pega Smart Claims Engine for Healthcare User Guide.

Each portal provides access to features supporting the role common to processing systems. There is overlap between features, menu items, and functionality between portals. Careful consideration is given to features available in each portal to cover many business needs. You can customize content to display any data integrated into the application. SCE portals come with extension points to support custom user interface requirements.

Key considerations[edit]

When you extend SCE portals, apply the following guidelines:

  • Always use predefined extension points when available. This reduces impact during upgrade.
  • Use the screen space to maximum effect by focusing on the information required to complete the task at hand. Too much information may slow the screen performance or overwhelm the end user. Too little information will require the user to look to external sources slowing productivity.
  • Review content of the included portals as a starting point. Sections can be added but the recommended approach is to update the extension sections with additional properties.
  • Extension points for specific interface screens can be found by browsing the live UI. For additional instructions, see Pega Smart Claims Engine for Healthcare Implementation Guide.
Portal UI Image.png
  • Rules overridden in the implementation layer will take precedent over updated product rules. Review release notes to identify when new enhancements can be used instead of a custom code.

Use case examples[edit]

The following figures show examples of how you can extend SCE portals:

Adding member information on the main claim display
Adding credentialing data
Adding financial data

References[edit]

Pega Smart Claims Engine for Healthcare Implementation Guide

Extending the application

SCE user guide