Table of Contents

Performing mass updates in Pega Product Composer for Healthcare

Pega Product Composer for Healthcare provides the Mass Update wizard. Use this feature to save time when you need to perform modifications across multiple entities by adding, updating, or removing new and existing benefits and groupers within a set of selected target benefit sets, product templates, products, and plans.

You can modify cost shares, such as copayments, coinsurance, and deductibles, and other data, such as limits and authorization requirements. The data you enter is populated in the targets you choose and the entities will no longer use inheritance.

For example, a new regulation requires the removal of the copayment for preventive care benefits in all small group HMO and PPO plans. You can use Mass Update to set the copayment to N/A for all the plans at one time.

Prerequisite

To perform mass updates, you must have the HC_USA_Product_Composer:MassUpdate access role assigned to your access group. By default, the Pega Product Composer for Healthcare administrator is assigned this access role.

Check your configuration before you perform mass updates to avoid an error message during the process.

The Mass updates feature does not validate the configuration on groupers and their contained benefits for the following cost shares: Lifetime maximum, Out-of-pocket maximum, Annual maximum, Deductible, Limit, and Eligibility. These cost shares can be configured in either the grouper or the benefit, but not in both. For example, you cannot have an Ambulance grouper that contains the Ambulance air benefit and the Ambulance air benefit with cost shares defined on both the grouper and the benefit.

Because used benefits in your context might have these cost shares defined, you need to ensure that the benefits are pushed to a grouper that does not have the benefits defined.

  1. In the header of Dev Studio, click Launch web interface > Product Development.
  2. In the navigation panel of your work area, click Process Entities > Update.
  3. Click Run mass updates and select the entity that you are updating, for example, Product Template.
    This selection determines the context for the application to select source benefits or groupers and the targets that receive the updates.
  4. In the Benefit/Grouper list, select either the benefit or grouper as the source of data for the update.
    For this example, Benefit is selected.
  5. In the Add list, select an option to indicate whether you are adding, updating, or removing information.
    For this example, Add is selected.
  6. In the New/Used list, select one of the following:
    • New. Then select the benefit or grouper from the list.
      All benefits and groupers are available to select as targets. The new benefit or grouper is inserted into the product template so that it inherits cost shares, deductibles, or visit limits.
    • Used. Then to further define the data, select options from the Network, Grouper, or Benefit lists.

    The following example shows that the MRI benefit for the PPO Full Network and the Imaging grouper from the Producttemplate4000 (01-01) product template is the source for the mass update.

    Selections in the Mass Update wizard
  7. Click Continue as necessary and navigate to the last step of the wizard.
  8. On the last step of the wizard, specify search criteria, set filters, and validate your search criteria.
    • If you selected New in step 6, a message displays that the benefit or grouper inherits the cost shares information. You cannot edit the values.
    • If you selected Used in step 6, the data is loaded from the selected product template in this example and is available for editing.
  9. Click Finish.

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