Eligibility Callout Rules
By defining callout rules the services provided by external components can be called from within the eligibility check.The Callout is triggered during the processing of an eligibility check when it encounters a callout rule. Essentially a callout can be set up by specifying the definition of the callout interface plus the conditions under which it is to be executed; together they form the callout rule. ;The callout interface works by sending a web service request and receiving and processing the response. By using the flexibility of dynamic logic, any externally used format can be adhered to.
The setup of callout rules is a combination of functional setup in a UI page of OHI Claims Adjudication and technical setup in the OHI Claims Adjudication properties*. Presented below are the fields of the functional setup.
(*) Refer to the Installation Guide for a description of the technical setup. Note that the technical setup must be present in order to successfully execute a callout rule (otherwise a processing error is raised on applicable eligibility responses).
Field | Description |
---|---|
Code |
The identifying code of the callout rule (this code is used in the specification of technical configuration parameters in the OHI Claims Adjudication properties file) |
Description |
The description of the callout rule |
Condition |
The dynamic logic condition that is executed to determine if the callout rule must be executed for an eligibility check |
Function |
The dynamic logic function that is executed to handle the callout |
Enabled? |
Is the callout rule enabled? |
Because response logic is always specified (within the function), the external component is required to send back a response including a message body (e.g. not just a HTTP 200 status code).