C1-PYINDRVAN

This algorithm is invoked when the status of the pay instruction is changed to Derivation in Progress. It derives the following:

• Policy using the policy number

• Plan using the plan number

• Member using the member identifier type and member identifier

• Payee account using the account identifier type and account identifier

If the policy, plan, and member information is available, it validates whether the member is covered under the specified plan of the policy. However, if the policy and plan information is available, it validates whether the plan is included in the specified policy. If the derivation and validation process is successful, the related object information is derived for policy, plan, and/or member from the system.

However, if the derivation and validation process fails, the related object information is not derived for policy, plan, and/or member and the status of the pay instruction remains as Pending.

In addition, the system determines whether the pay instruction must be reconciled at the member, plan, or policy level depending on the information available in the pay instruction. If the policy, plan, and member information is available, the pay instruction is reconciled at the member level. If the policy and plan information is available, the pay instruction is reconciled at the policy plan level. However, if the policy information is available, the pay instruction is reconciled at the policy level.

It contains the following parameters:

• Unsuccessful Processing Status - Used to specify the status code to which you want to transition the pay instruction when the derivation and validation process fails.

• Pay Instruction Matching Level Characteristic Type - Used to specify the characteristic type which indicates whether the pay instruction must be reconciled at the member, plan, or policy level. This type of characteristic is defined on the pay instruction. Here, you must specify a characteristic type where the characteristic entity is set to Payment Instruction.

• Member Matching Level Characteristic Value - Used to specify the value that you want to define for the characteristic type specified in the Pay Instruction Matching Level Characteristic Type parameter when the pay instruction must be reconciled at the member level.

• Plan Matching Level Characteristic Value - Used to specify the value that you want to define for the characteristic type specified in the Pay Instruction Matching Level Characteristic Type parameter when the pay instruction must be reconciled at the policy plan level.

• Policy Matching Level Characteristic Value - Used to specify the value that you want to define for the characteristic type specified in the Pay Instruction Matching Level Characteristic Type parameter when the pay instruction must be reconciled at the policy level.

All these parameters are mandatory.