Data Access Group Integration Point
Purpose
This chapter describes the data access group integration point messages and how they are used by external interfaces to initially load data access groups into OHI Claims Adjudication and Pricing and to keep the OHI Claims Adjudication and Pricing up-to-date with data access groups in the source system.
In order to differentiate user access over claims and authorizations, OHI Claims Adjudication and Pricing requires a notion of data access groups maintained (mastered) outside of OHI Claims Adjudication and Pricing. Where this is the case, OHI Claims Adjudication and Pricing needs to store an up-to-date copy of these data access groups. This copy in OHI Claims Adjudication and Pricing is maintained by external (not part of OHI Claims Adjudication and Pricing) interfaces using data access group integration point messages.
The external interfaces will initially load details of data access groups from the 'master' systems into OHI Claims Adjudication and Pricing through data access group integration point message calls. Thereafter, they will monitor the 'master' system(s) for updates and new data access groups and make message calls to provide OHI Claims Adjudication and Pricing with updated details and to add new data access groups.
Design principles
XML Messages
This interface is implemented by XML messages. The XML messages are defined in pairs using XML schemas (XSD’s). Each pair of messages consists of a request and a response. Request messages are sent by external interfaces. Each contains a data access group that needs to be created or updated in OHI Claims Adjudication and Pricing. For each request message that an external interface sends, exactly one response message is returned. The response message either indicates the result of storing or updating a data access group in OHI Claims Adjudication and Pricing.
This chapter does not discuss logging, time stamps and message (correlation) identifiers (e.g. as needed for matching a given response message with its request message). These aspects are covered by the overall messaging framework. Data access group matching
In order for OHI Claims Adjudication and Pricing to be able to recognize when an update to a data access group is being sent and to know which data access group in OHI Claims Adjudication and Pricing is to be updated, a data access group code is used. The data access group code is a unique id from the source system that external interfaces will always include with each data access group.
OHI Claims Adjudication and Pricing stores the code with its copy of each data access group. When the details of a data access group are received in a message, OHI Claims Adjudication and Pricing will consider the details to be a new data access group if there is not already a data access group stored with the same code and it will consider the details to be an update to an existing data access group if there is one with the same code.
Request Message
Each data access group request message contains a single data access group (that is to be created or updated in OHI Claims Adjudication and Pricing ). A standard approach is used for 'store requests'. The implementation guide for common integration point features describes this approach. It indicates what is expected in these request messages and how they will be handled by OHI Claims Adjudication and Pricing when they are received.
Data access group request messages have the following structure (see also the corresponding XSD):
<dataAccessGroupRequest code="" description=" " transactionSourceCode="" referenceCode="" accessRestrictionCode="" />