Eligibility Validation Rules

A validation rule is a user defined validation of the data elements on the eligibility check e.g. a person born in a certain country, is aligned to a certain provider etc. The result of failing the validation is that a message is attached to the eligibility response and/or a function dynamic logic is executed that can set certain fields and can also add messages to the eligibility response. Fatal messages prevent that the eligibility check is approved.

Table 1. Eligibility Validation Rules

Field	Description
Code	The identifying code of the validation rule
Description	The description of the validation rule
Condition	The dynamic logic condition that is executed to determine if the message must be attached to the eligibility response and/or the dynamic logic function must be executed
Function	The dynamic logic function that is executed if the conditions are met
Message	The message that is attached to the eligibility response if the conditions are met (the message placeholders are described below)
Enabled?	Is the validation rule enabled?

Message Placeholders

The following table specifies the placeholder values for messages that are attached to eligibility responses when a validation rule is applied:

Table 2. Message Placeholders

#	Eligibility Response
0	The code of the rule
1	The description of the rule
2	N/A
3	N/A
4	N/A
5	N/A
6	N/A
7	N/A
8	N/A
9	N/A