View Product pages

In addition to a setup page used for configuring a single product, two extra product related pages are provided in the application; one for viewing products and one for viewing the product build results.

  • The View Products page is used to search for products and view multiple products at once. It is not possible to create or update products in this page, but deleting products is done through this page.

  • The View Generated Product page is used to view all the product benefit specifications that have been created for a product. This page shows a combination of product benefit specification and benefit specification attributes and details in a single record. This allows the user to view the contents of a product in the structure in which it will be exported to a claims adjudication engine.

View Products

It is not possible to modify products in this page, but clicking on the "Setup Page" hyperlink will open a new tab of the "Setup Product" page displaying the (editable) configuration of the selected product. The "Build Page" hyperlink opens the "View Generated Product" page displaying all the product benefit specifications for the product that are a result of the build function.

The page is accessed though the Products menu, under the sub-menu item Products, with the link "Overview".

The page is represented as a single table and each row displays the following attributes of a product:

  • Code (with hyperlink to Setup Product)

  • Description

  • Brand

  • Product Line

  • Build

  • Status

  • Hyperlink "Generated Product"

  • Product Family

  • Funding Arrangement

  • Currency

  • Priority

  • Valid?, shows the validation status of the product

  • Fatal Messages, shows the number of fatal messages resulting from product validation

  • Source Product; contains a product code if the product is based on a non-template (or prototype) product

  • Source Template; contains the code of the template that the product is based on

Any dynamic fields defined for a product appear in the overflow of each line.

The first column is a check-box, this is used to select rows one by one or to (de)select all rows with the topmost check-box. The "Set Status" button will set the status of the selected products based on the selected option (Edit, Review, Test or Approved) in the drop-down. Selecting the Test option will also trigger the build function for all the products that are checked, have the status Edit and have been reviewed and released to be loaded into an OHI Claims Adjudication test environment. Note that this functionality is only available for users that have an access restriction of type Set Product Status.

View Generated Product

This page displays all the product benefit specifications of a single product. Each row displays the attributes and details of the following product components:

  • Product benefit specification attributes

  • Benefit specification attributes

  • Product benefit specification values

  • Product benefit specification limits

The page is not directly accessed though the menu. It is accessed either through the "Build Product" link in the View Products page or through the "Go To Generated Product" option of the drop-down button "Product" in the Setup Products page.

The page is represented as a single table and each row displays the following attributes:

  • Code

  • Description

  • The type of the benefit specification

  • Product Benefit Specification Values; displays the product benefit specification parameter values

  • Product Benefit Specification Stop Limits; displays the product benefit specification limits with reached action "Stop"

  • Product Benefit Specification Continue Limits; displays the product benefit specification limits with reached action "Continue"

  • Product Benefit Specification Reinsurance; displays the alias codes that represent reinsurance parameters

  • Proc. (Procedure) Group

  • Proc. (Procedure) Condition

  • Diag. (Diagnosis) Usage

  • Diag. (Diagnosis) Group

  • Diag. (Diagnosis) Condition

  • Diag. (Diagnosis) Type

  • Product; displays the product provider group scope

  • Specific Networks; displays multiple groups (including assignment labels) and their scope

  • Regime

  • Auth. (Authorization) Missing?

  • Case Definition

  • Claim Form Type

  • Modifiers; displays multiple modifiers and their scope

  • Specialties; displays multiple specialties and their scope

  • Location Types; displays multiple location types and their scope

  • Conditions; displays multiple conditions

  • Empl. (Employer) Usage

  • Employer Country Region

  • Employer Country Region Group

  • Pers. (Person ) Usage

  • Person Country Region

  • Person Country Region Group

  • Prov. (Provider) Usage

  • Provider Country Region

  • Provider Country Region Group

  • Age From

  • Age To

  • Gender

  • Priority

  • Start Date

  • End Date

  • Active?

Any dynamic fields defined for the benefit specification are visible in this page. Dynamic fields defined for the product benefit specification value and limit do not appear on the page.

This page allows the user to use both the advanced and the quick search on several details. For example, this allows the user to search on all product benefit specifications that contain a specific (combination of) condition(s). The following details are included in the search functionality:

  • Specific Networks

  • Conditions

  • Modifiers

  • Specialties

  • Location Types

  • Product Benefit Specification Values (only on cover withhold category codes, not on values)

  • Product Benefit Specification Limits (only on limit codes, not on values) The page also allows the user to search for empty values (e.g. product benefit specifications without a modifier). The following fields allow for searching on empty values:

  • Modifiers

  • Specialties

  • Location Types

  • Employer Country Region / Employer Country Region Group

  • Person Country Region / Person Country Region Group

  • Provider Country Region / Provider Country Region Group