C1-HLTPRDVAL

This algorithm is invoked when you execute the Health Product Health Plan (C1-HCPHP) periodic monitor batch or click the Submit for Processing button in the Inbound Message screen. This algorithm validates the Health Product and Plan Inbound Message, which is in the Pending status, to check the following conditions:

  • Whether the specified Inbound Message Type and Inbound Message Business Object are valid.

  • Whether the specified source system is valid and does exists in the Source System Extendable Lookup (C1-SourceSystemLookup).

  • Whether the mandatory data (such as health product code, description, product type, bundled product, start date, status) is specified in the health product.

  • Whether the mandatory data (such as health plan code, description, health product, start date, status) is specified in the health plan.

  • Whether the mandatory data (such as health plan code, charge, start date, pricing rule) is specified in the health plan pricing rules.

  • Whether the specified data for the lookup columns matches with those mentioned in the system.

  • Whether all of the switch columns either contain Y or N as values.

  • Whether the specified end date for health product, health plan, and health pricing rule is greater than the start date.

  • Whether the product is mapped to the division which exists in the system, and the product - division mapping is a one time process.

  • Whether the product code is mapped with the health plan exists in the system.

  • Whether the characteristic type mapped with the respective entity exists in the system.

  • Whether the specified pricing rule type for creating the pricing rule exists in the system in the Active status, and the pricing rule type - health plan mapping is a one time process.

  • Whether the specified price item and price item parameters for pricing rule eligibility are valid, and the price item parameters exist in the CI_​PRICE_​PARM table.

  • Whether the price item parameters that have parameter usage specified as Pricing Rule Eligibility Criteria are available while defining the pricing rule eligibility for the pricing rule.

  • Whether the entity type is specified as Health Plan and entity value as Health Plan Code while creating a pricing rule for a health plan.

Note:

This algorithm does not consider the following validations or checks:

  • No validation is performed between the date range of the product and health plan.

  • No check is performed whether the product is in the Active status while creating a health plan.

  • No check is performed whether the health plan is in the Active status while creating the health plan pricing rules.

  • No check is performed on the set of the pricing rule eligibility, which is defined on multiple pricing rules, for a price item.

  • No validation is performed if duplicate parameters are defined for a pricing rule.