Bookshelf v7.5: Siebel eHealthcare Integration Messages

Siebel eHealthcare includes a number of integration messages designed to support key business processes for the healthcare industry. Table 5 describes these messages by defining the message type, the message purpose, the target application, and where you can find more information about it.

Table 5. Siebel eHealthcare Integration Messages
Type	Message	Target Application	Description
ASI	Request Add/Cancel Group Policy Member	Policy Administration System	A message to add or cancel a group policy member. For information, see Application Services Interface Reference: Siebel eBusiness Application Integration Volume VI.
ASI	Response Add/Cancel Individual Policy Member	Policy Administration System	A message to add or cancel an individual policy member. For information, see Application Services Interface Reference: Siebel eBusiness Application Integration Volume VI.
ASI	Request Authorization	Referrals and Authorizations System	A message to search for appropriate providers. For information, see Application Services Interface Reference: Siebel eBusiness Application Integration Volume VI.
ASI	Request Benefit Detail	Benefits System	A message to submit information required for determining eligibility. For information, see Application Services Interface Reference: Siebel eBusiness Application Integration Volume VI.
ASI	Request Member Details Update	Membership System	A message to update demographic and contact details for a member. For information, see Application Services Interface Reference: Siebel eBusiness Application Integration Volume VI.
ASI	Request Preliminary Rating	Rating Engine	A message to request a preliminary rate based on census and plan information. For information, see Application Services Interface Reference: Siebel eBusiness Application Integration Volume VI.
ASI	Request Providers	Provider System	A message requesting benefit detail. For information, see Application Services Interface Reference: Siebel eBusiness Application Integration Volume VI.
ASI	Request Referral	Referrals and Authorizations System	A message to submit authorization request. For information, see Application Services Interface Reference: Siebel eBusiness Application Integration Volume VI.
ASI	Update Provider Details	Provider System	A message to update the demographic and contact details for a provider. For information, see Application Services Interface Reference: Siebel eBusiness Application Integration Volume VI.
VCML	Request Claim Status Date Request	Claim Administration System	A request message for claim status and date.
VCML	Request Claim Status Date Response	Claim Administration System	The response message to a request message for claim status and date.
VCML	Request Claims Adjudication Request	Claim Administration System	A message submitting claims detail to request for adjudication.
VCML	Request Claims Adjudication Response	Claim Administration System	The response message to an adjudication request. It may contain advice of amount payable and Explanation of Benefits.