Creating a Migration Set

Configuration Migration Sets

The application enables users to create configuration migration sets in the application user interface ^[1].

This page enables the user to select the top level migration items that are ready for migration and need to be included in the set. Within the context of the selected top level items, the user can select specific dependent items to exclude.

By default, the application excludes the following data from a new migration set:

• diagnosis

• procedures

• payers

• providers

The user has the option to override the default behavior, and include all diagnosis, procedures, payers, and providers that are linked to the selected configuration.

Including Configuration Items

The page offers two alternatives for creating a migration set. The first is creating a full set, which includes all configuration of the source environment. This is the default option.

The second alternative enables the user to handpick specific configuration ready for migration. If chosen, the page shows an overview of the all available configuration to select from.

Configuration is hierarchical in nature; complex configuration rules are a composite of basic configuration rules. For example, a process step is a composite of any combination of callout-, event-, pend- and validation rules. In turn, the pend rule comprises a dynamic logic condition and a message (and more) as well.

When the user selects a configuration rule, the application automatically determines what supporting configuration is required to successfully migrate the selected rule to the target environment.

For each available configuration item the application offers three options:

• Include all instances of that configuration item.

• Select specific instances of that configuration item.

• Remove all previously selected instances of that configuration item.

The last option does not add any items to the migration set, but instead provides a convenient way of quickly removing all instances of a configuration item from a migration set.

The second option, when selected, becomes a link that opens a new window. In this window the user can select specific instances of the configuration item to include in the migration set.

Below is the list of configuration items that can be included in a configuration migration data set. Each entry specifies which dependent items are auto-included and which dependent items can be excluded.

Table 1. Items that can be Included in a Configuration Migration Data Set

Top Level Item	Automatically Includes	Optional Excludes
access role	access restriction access restriction grant claim access restriction claim access restriction form currency data access group	claim form
activity type	dynamic field usage[2] flex code system parameter set parameter set dynamic line	-
address type	-	-
advice response definition	-	dynamic logic
authorization form	-	-
authorization regime	authorization regime period authorization regime period tranches coverage label currency	dynamic logic message
basket	basket detail currency	-
benefit specification	benefit priority benefit specification dynamic logic benefit specification location type benefit specification modifier benefit specification provider group benefit specification specialty claim form type diagnosis type	authorization regime case definition country region country region group coverage regime[3] diagnosis group dynamic logic limit (displayed as adjudication limit in the UI) location type message modifier post benefits regime procedure group provider group reservation regime specialty waiting period regime
boilerplate text	-	-
bundled amount	bundled amount category episode category episode definition reimbursement method type	message
callout definition (displayed as claim callout rule in the UI)	claim callout rule skip tag skip tag claim form	classification scheme dynamic logic
case definition	ancillary inclusion rule	diagnosis group dynamic logic message procedure group
charged amount	charged amount classification charged amount modifier reimbursement method type classification	dynamic logic message modifier procedure group
claim event rule	claim event rule form	claim form dynamic logic message group procedure group
claim form	claim form type insurance type	flex code system
claim transaction event rule	-	dynamic logic
classification scheme	brand classification classification scheme detail classification scheme detail modifier classification scheme form classification priority funding arrangement product category product category dimension product category dynamic logic product family product line provider category provider category dynamic logic provider category specialty	claim form diagnosis group dynamic logic location type group message modifier procedure group product provider group specialty
combination check	combination check claim form combination check procedure	claim form dynamic logic message procedure group
contract reference	-	-
country	bank account validation	dynamic logic
country region	country	-
country region group	country region group detail	country region
coverage regime	count towards limit cover withhold rule cover withhold category coverage label coverage regime period coverage regime period tranche currency	limit (displayed as adjudication limit in the UI) message
covered service tier	-	-
currency	-	-
derivation rule	derivation rule form	claim form dynamic logic
diagnosis group	diagnosis group detail	-
diagnosis type	-	-
diminishing rate	currency diminishing rate block diminishing rate block amount[4] diminishing rate block size[4] reimbursement method type	message
dynamic check	dynamic check claim form	claim form dynamic logic message product
dynamic field usage (displayed as usage in the UI)	dynamic logic field flex code system message	-
dynamic logic	dynamic logic reference sheet message	reference sheet
eligibility response definition	callout rule process step rule step validation rule	dynamic logic message
episode definition	episode category episode criteria payer	diagnosis group dynamic logic message procedure group
exchange rate	currency	-
external intervention rule	brand external intervention rule form	claim form diagnosis group dynamic logic message group pend reason procedure group unfinalize reason group
fee schedule	classification currency fee schedule line fee schedule line classification fee schedule line modifier fee schedule modifier reimbursement method type	contract reference dynamic logic message modifier procedure group provider group
fee schedule line[5]	classification currency fee schedule fee schedule line classification fee schedule line modifier fee schedule modifier reimbursement method type	contract reference dynamic logic message modifier procedure group provider group
financial hold type	-	-
flex code group	flex code group detail	flex code system
flex code system	dynamic logic field flex code flex code field usage flex code set detail flex code system message
floorplan	floorplan tag details
gender identity	-	-
geographic region	geographic condition	dynamic logic
identifiers type	access restriction
insurable entity type	-	-
limit (displayed as adjudication limit in the UI)	limit sub limit[6]	dynamic logic message
insurance type	insurable entity type supported insurable entity type	-
location type	claim form type	-
location type group	location type group detail	location type
marital status type	-	-
message	-	-
message creation scenario	-	dynamic logic
message group	access restriction message group detail	message
modifier	-	-
payment function	reimbursement method type	dynamic logic message
pend reason	access restriction	dynamic logic
post benefits regime	cover withhold category coverage label post cover withhold rule	dynamic logic message
prefix	-	-
pricing option	-	-
pricing template	pricing section pricing section option	pricing option
procedure group	procedure group detail	-
process field derivation rule	process field derivation rule form process field derivation priority	claim form dynamic logic location type group procedure group
product	brand cover withhold category currency funding arrangement product benefit specification product benefit specification limit product benefit specification reinsurance product benefit specification value product family product limit product line product priority product provider group	authorization regime benefit specification[7] case definition country region country region group coverage regime diagnosis group dynamic logic limit (displayed as adjudication limit in the UI) location type message modifier post benefits regime procedure group provider group reservation regime specialty waiting period regime
provider assignment type	-	-
provider group	provider group affiliation	-
provider pricing clause[8]	adjustment execution phase adjustment percentage brand classification currency diminishing rate block amount[9] diminishing rate block size[9] funding arrangement pricing external intervention rule form pricing priority pricing rule pricing rule classification pricing rule modifiers pricing rule reimbursement method type product category product category dimension product category dynamic logic product family product line provider category provider category dynamic logic provider category specialty provider limit category provider limit height provider pricing clause claim classification provider pricing clause claim line classification provider pricing clause classification scheme provider pricing clause dynamic logic provider pricing clause restrict reimbursement method reference sheet reference sheet line[9] skip tag skip tag claim form	bundled amount charged amount claim form classification scheme contract reference diagnosis group diminishing rate dynamic logic fee schedule location type group message message group modifier payment function pend reason procedure groups product provider group specialty unfinalize reason group
reference sheet	dynamic field usage[10] reference sheet line[9]	-
relation link type	-	-
reservation regime	coverage label	dynamic logic message
service type	-	-
settlement reason	access restriction	-
specialty	-	-
tag type	tag type message	message
title	-	-
transaction scenario	-	dynamic logic
transaction source	transaction source usage	-
unfinalize reason	-	-
unfinalize reason group	unfinalize reason group detail	unfinalize reason
waiting period regime	-	message
waiver reason	-	-
widgets	-	-

Including Diagnosis, Procedures, Payers and Providers

If the user chooses to include diagnosis, procedures, payers and providers reference data in the migration set, then the application also includes the setup configuration that is required, regardless of whether it is explicitly selected by the user.

For example, if the migration set includes provider X, and provider X has specialty Y, then specialty Y is auto included in the migration set.

The following table specifies which setup configuration is auto-included, if diagnosis, procedures, payers or providers are included in the migration set.

Table 2. Items that are auto-included if diagnosis, procedures, payers or providers are included

Reference Data	Automatically Includes
diagnoses	access restriction diagnosis setting
procedures	access restriction procedure setting
payers	access restriction (payer and brand) brand payer code
providers	individual provider: bank account number bank account validation country country region dynamic logic (bank account validation) prefix provider (service address organization provider) provider specialty provider title rendering address service address specialty title provider identifier organization provider: bank account number bank account validation country country region dynamic logic (bank account validation) provider (parent organization provider) provider specialty provider identifier service address specialty

Optional Excludes

By default, when the user selects a configuration rule, the application automatically determines and includes the supporting configuration that is required to successfully migrate the selected rule to the target environment.

This is not always desirable. For example, the supporting configuration may just be a placeholder, not intended to be migrated.

The exclude options enable the user to overrule the supporting configuration from automatic inclusion.

Dynamic Field and Record Usages

Configuration items can be extended with dynamic fields and records. If an extended item is included in the payload, the dynamic field and record values and the related dynamic field usages are automatically included as well. The target environment requires the dynamic field usages in order to know where it can find and update the dynamic field values.

Intended Usage

The configuration migration functionality described here, is intended to be used by an expert user that is aware which configuration changes are ready for migration, and which are not.

After the configuration migrations set is created, the next step is to build the Configuration Migration Set. In this step, the payload is generated as per the specifications of the configuration migration set.

Whenever the user changes a configuration migration set, for example by adding new items, the set needs to be rebuilt, so that the changes are reflected in the payload.

The # Items in the configuration migration set is the number of items that the system detected during the creation or latest update of the set.

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1. JET Menu > Operations > Data Exchanges > Configuration Migration Sets

2. An activity type can rely on a single dynamic field usage record that serves as an integral part of the activity type by connecting the parameter sets of the activity type to their definition. This dynamic field usage record is not visible in any user interface page, but is migrated as part of the activity type.

3. Excluding coverage regimes will automatically exclude limits.

4. Diminishing rate block amounts and sizes that are linked to a provider pricing clause are not included as dependent items of the diminishing rate. These are dependent items of the provider pricing clause.

5. There is no checkbox (for adding/removing all items) available for top level item Fee Schedule Line. This top level item is meant for selective migration of fee schedule lines; migrating all fee schedule lines can be done by selecting all fee schedules.

6. The limits referenced by the sub limit are also included

7. Excluding benefit specifications will automatically exclude the other optional excludes that belong to benefit specifications.

8. Provider pricing clauses can be created by using drafts. Each clause is linked to the draft from which it is generated. Since the draft clauses are not within the scope of the migration function, the reference to the original draft is not migrated. In addition to the reference, the clause also stores information that identifies the draft clause in two character fields; these fields are migrated.

9. Diminishing rate block amounts and sizes that are linked to a provider pricing clause are always included as dependent items of the provider pricing clause, even when the provider pricing clause is migrated without the diminishing rate.

10. Each reference sheet relies on a single dynamic field usage record that serves as an integral part of the reference sheet by connecting the reference sheet to its definition. This dynamic field usage record is not visible in any user interface page, but is migrated as part of the reference sheet.