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Implementing the custom plan API

When existing healthcare plans do not meet customer requirements, a sales representative or a partner sales representative creates a custom plan request either directly from the Quote Plan Selection page or from the Create menu, as a standalone request. Pega Sales Automation for Healthcare uses the Custom plan API to send the request for a custom plan to Pega Product Composer for Healthcare. To change the logic that the application uses to send the request, modify one or more of the following API rules:

  • Case type name: New plan request
  • Class name: PegaHCSPM-Work-CustomPlanRequest
  • Flow Name: spmRequestCustomPlan
  • Flow action: ExcludeBenefits

    This rule is invoked in the New plan request flow, after the step Not-covered and excluded benefits/services.

  • Data transform: PostBenefitsExclude

    This is a post-processing data transform in the flow action. This data transform will trigger the REST API call only when a New plan request is created by selecting the Copy data from standard plan option.

    Extend to handle a simulation or make a REST call in a different way.

  • Data transform: RequestCustomPlanPOSTExt

    Extend to handle the response in a different way.

  • Data transform: spmGetPlanID

    Extend to simulating PLAN ID creation differently.

  • Data Page: D_RequestCustomPlan

    This data page has a REST connector that is responsible for making the REST call.

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