Sequences in Smart Claims Engine

In Smart Claims Engine, one or more modules are combined to create a sequence. A sequence runs the modules in the order selected when the sequence is created. This allows for unique configuration of the claim adjudication processing steps.

For example, you might create a sequence in Smart Claims Engine called “Validation processing”. The sequence could be made up of five modules, in the following order:

A claim encountering this sequence would enter each of the modules in the defined order. The order is important. In this example, the “Member match” module is placed before the “Policy selection and eligibility” module – because the member must be selected before the appropriate policy and associated eligibility is determined.

Sequences may be reused across multiple orchestrations. Once a sequence has been added to an orchestration, it may not be removed from the Smart Claims Engine application.

If desired, you may extend sequences by calling initialization and finalization rules – these can be used to initialize or finalize any values before or after the sequence is run. 

Sequences produce a result status that is used to determine whether to continue to the next sequence, restart the sequence, restart the orchestration, or stop processing.

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