Transaction Creation Scenarios
Transaction creation scenarios provide the ability to configure some aspects of creating claim transactions and financial transactions. The scenarios determine exactly what values claim transactions and financial transactions will have. This section describes the possibility for adding parameters to transaction creation scenarios, how to create the scenarios, and the dynamic logic functions needed for creating claim transactions and financial transactions from claims.
Each claim transaction creation scenario includes:
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a reference to a dynamic logic condition (indicating criteria for selecting the scenario for use with a claim)
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a scenario selection priority (determines the order in which scenarios are considered for selection: 1 means highest priority)
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references to the names of the dynamic logic functions that are to be used for creating transactions; a reference to a single function of each of the following types is required:
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Create Claim Transaction Header
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Create Claim Bill (if bills are being used, thus optional)
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Create Claim Transaction Claim Line
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Create Financial Transaction
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Create Financial Transaction Detail
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Change Financial Transaction (optional)
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Before scenarios can be created, any parameters that are required need to be added (this only needs to be done once regardless of how many scenarios are to be created).
The creation of a given scenario needs to be done starting with the dynamic logic functions and the dynamic logic condition. Once the functions that are required for a scenario have been created, the scenario itself may be created. Note that it is possible to use a given dynamic logic function in more than one scenario.
Add Parameters to Transaction Creation Scenarios
Dynamic fields may be added to the transaction creation scenario entity in the same way that dynamic fields may be added to other entities. Refer to the "Extensibility" chapter of the Configuration Guide for details.
The values of the dynamic fields on the transaction creation scenarios are available from the dynamic logic functions and are therefore suitable for passing values to the dynamic logic that are 'fixed' for a given scenario.
Create Dynamic Logic Conditions
The dynamic logic conditions are standard dynamic logic conditions that determine if a particular scenario should be selected or not.
If more than one scenario will be used, each scenario requires a dynamic logic condition to indicate with which claims a scenario is to be used. The conditions need to specify conditions on claims. When a claim is finalized, the conditions of each scenario are evaluated against the values of the claim to see if the scenario should be used. The scenarios are evaluated in the indicated priority, and the first one that has conditions that are met by the values of the claim is selected.
A scenario without a dynamic condition is considered to be a suitable match for all transactions. To avoid the possibility of there being no match for a claim, include a scenario without a condition with a number for priority that is higher than any other number used.
If only one scenario is being used, it should not have a condition.
The dynamic logic conditions are the same as dynamic conditions used elsewhere in Claims. Refer to the "Dynamic Logic" section of the Developer Guide and the "Dynamic Logic Conditions" section of this page for more details.
Create Dynamic Logic Functions
There are several types of dynamic logic functions that are needed for creating a claim transaction. These types are described in the Dynamic Logic Function section. Create the dynamic logic functions that are needed for the scenarios that are to be created. Each scenario requires a function of each of the following types:
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Create Claim Transaction Header
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Create Claim Transaction Bill (if bills are being used)
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Create Claim Transaction Claim Line
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Create Financial Transaction
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Create Financial Transaction Detail
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Change Financial Transaction
The functions transfer details from the base claim and related tables to claim transactions. This logic is intended both for basic formatting and transfer of values to claim transactions and for creating and changing financial transactions, financial transaction details and process data.
The dynamic logic functions should have the minimum logic that is needed to prepare the claim transactions and financial transactions. The logic should be as lightweight as possible and be compatible with execution during the claim finalization 'transaction'.
Functions may be reused in more than one scenario and parameters may be defined for scenarios and passed to the dynamic logic functions. These possibilities and the possibility of having multiple scenarios can be used to make choices on how to create the transactions that are required in the most optimal way. For example, if dynamic logic were to have a lot of conditional statements on the same condition, a decision could be made to create a scenario for each possible value of the condition and separate the logic. Likewise, it may be possible for multiple scenarios with very similar logic to be combined through the use of parameters.
For specific details and examples of each type of dynamic logic function, refer to the Dynamic Logic Functions section. For an overview of the context in which the dynamic functions are used, refer to the Overview section.