Queue Definition

Queue definitions configure how the Worklist framework routes work items for pended claims. When a work item is created, the framework evaluates the configured queue dimensions and selects the appropriate queue.

Data Model

The following section describes the available data elements on a queue. Data elements identified as mandatory must have a value. All other data are optional.

This entity represents the queue and stores the following fields:

Table 1. Queue Configuration Fields

Field	Description
Code	Mandatory. Unique code that identifies the queue.
Description	Mandatory. Short description of the queue.
Priority	Mandatory. Defines the queue’s priority using a number. A lower number indicates a higher priority.
User Role	Mandatory. Defines the eligible user who can work on the work item assigned to the queue. Need user access role to the user.
Admin Role	Mandatory. Defines the eligible administrator who can assign and reassign work items for the queue. Need admin access role to the user.
SLA Time UOM	Unit of measure for the SLA time value. Supported values are D for days and M for minutes.
SLA Due Time Value	Number of units, days or minutes, within which the work item must be resolved.
SLA Risk Time Value	Number of units before the SLA due time at which the work item is flagged as at risk.
Global SLA Definition	Adds a record-level SLA computed from the claim version creation date.
Ind Enabled	Defines whether the queue is enabled. If disabled, the queue is not considered during work item creation or processing.
Data Access Group	The code used in the context of user access restrictions on this queue.
Dynamic Logic Evaluation	Dynamic logic condition that must be met during work item creation if the queue applies.
Dynamic Logic Parameters	Dynamic logic function used to set extensibility fields, priority, work item SLA due time, or global SLA due time.
Queue Pend Reasons	Defines the list of pend reasons selected for the queue.
Queue Group Messages	Defines the queue group messages selected for the queue.
Brand	Defines the eligible brand for the queue.
Claim Form	Defines the eligible claim form for the queue.
Claim Type	Defines the eligible claim type for the queue.
Process Type	Defines the eligible process type for the queue.
Charged Amount From	Defines the charged amount from value for the amount range.
Charged Amount To	Defines the charged amount to value for the amount range.
Charged Currency From	Defines the eligible charged amount from currency.
Charged Currency To	Defines the eligible charged amount to currency.
Allowed Amount From	Defines the allowed amount from value for the amount range.
Allowed Amount To	Defines the allowed amount to value for the amount range.
Allowed Currency From	Defines the eligible allowed from currency.
Allowed Currency To	Defines the eligible allowed to currency.
Covered Amount From	Defines the covered amount from value for the amount range.
Covered Amount To	Defines the covered amount to value for the amount range.
Covered Currency From	Defines the eligible covered from currency.
Covered Currency To	Defines the eligible covered to currency.
Payer	Defines the eligible payer for the queue.
Dynamic Fields	Dynamic fields for the usage.

Queue Configuration Constraints

• Only data access groups with access restriction type Data access group for queue definition can be assigned to a queue.

• When creating or updating a queue, Amount To can only be specified when Amount From is also present, and Amount To must be greater than or equal to Amount From.

• When creating or updating a queue, Currency From and Currency To must be the same currency code for each amount dimension.

• The SLA Due Time Value and SLA Risk Time Value must each have a unit of measure.

• The SLA Risk Time Value must be less than the SLA Due Time Value.

• The SLA Risk Time Value cannot be specified unless the SLA Due Time Value is also provided.

Global SLA Definition

A global SLA definition configures a record-level SLA that is computed from the latest claim version creation date.

It is optionally linked to a Queue Configuration and applies the same SLA deadline to all work items created from that record, regardless of when the work item itself was created.

Global SLA Definition Data Model

This entity stores the following fields:

Table 2. Global SLA Definition

Field	Description
Code	Mandatory. Unique code of the global SLA definition.
Description	Mandatory. Short description of the global SLA definition.
SLA UOM	Unit of measure for the SLA values. Supported values are D for days and M for minutes.
SLA Due Time Value	Number of days or minutes within which processing of the associated record is expected to be completed.
SLA Risk Time Value	Number of days or minutes after the SLA start time at which the associated record is considered at risk.
Queue Configuration	Queue configuration associated with the global SLA definition.

Constraints

• The SLA Due Time Value and SLA Risk Time Value each require a unit of measurement.

• The SLA Risk Time Value must be less than the SLA Due Time Value.

• The SLA Risk Time Value cannot be specified unless the SLA Due Time Value is also provided.

Work Item Notifications

Notifications are configured on the Queue Definition. A notification can be sent when any of the following events occurs:

• A work item is assigned to a user.

• Feedback is requested from a user.

• A user provides the requested feedback.

If a notification dynamic logic function is not configured for an event, no notification is sent for that event.

Work Item Notification Data Model

This entity stores the following fields:

Table 3. Work Item Notification Fields

Field	Description
Code	Required. Unique code that identifies the notification definition.
Description	Required. Description of the notification definition.
Assigned Notification	Function dynamic logic that creates the notification when a work item is assigned.
Feedback Request Notification	Function dynamic logic that creates the notification when feedback is requested.
Feedback Response Notification	Function dynamic logic that creates the notification when feedback is provided.
Queue Configuration	Queue configuration associated with the notification definition.

For more information, see Work Item Notification dynamic logic.