Orchestrations in Smart Claims Engine
Pega Smart Claims Engine orchestration layer
One or more modules are combined to create sequences. An orchestration layer in Smart Claims Engine is created by combining one or more sequences. The orchestration structure also allows inclusion of configurable initialization and finalization rules, as well as the capability to define the next steps (if any) after the orchestration completes.
As with sequences, orchestrations can be run from start to finish, but the orchestration can be stopped when claim issues are recognized to route the work to an appropriate workbasket for resolution and resubmission into the orchestration.
Out-of-the-box sample orchestrations
Smart Claims Engine is delivered with two orchestrations in the sample layer: Adjudication and Adjustment.
The Adjudication orchestration is designed to process a new claim from beginning to end.
The Adjustment orchestration identifies and voids or cancels the original claim and processes the submitted adjustment, if applicable.
When you create an orchestration in the Smart Claims Engine, you can use a decision table to derive the orchestration to process the claim. The orchestration may also be determined via other channels, such as being defined in an API.
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