Eligibility Checker Automation
- Sheni Singhal
- Ashutosh Kumar
Health Cloud
This page contains details on how to trigger Eligibility by creating Member Plan and and refresh Member Plan over a period of time :
Required fields to create Member Plan
How to refresh Member Plan
Required Fields to Create Member Plan
Below is the list Of Fields that are required to Create a Member Plan Record –
Field Name | Field API Name |
Name | Name |
First Name | medicalcoverage__First_Name__c |
Last Name | medicalcoverage__Last_Name__c |
Birth Date | medicalcoverage__Birth_Date__c |
Member Number | MemberNumber |
Payer Name | medicalcoverage__Payer_Name__c |
Payer Id | medicalcoverage__Payer_Id__c |
NPI | medicalcoverage__NPI__c |
API Status | medicalcoverage__API_Status__c |
As Of Date | medicalcoverage__As_of_Date__c |
PrimarySecondary Tertiary | medicalcoverage__PrimarySecondaryTertiary__c |
Sample Apex Code Snippet to Create a Member Plan Record
MemberPlan oMemberPlan = new MemberPlan();
oMemberPlan.Name = 'Primary-CIGNA(62308)';
oMemberPlan.medicalcoverage__First_Name__c = ‘First Name’;
oMemberPlan.medicalcoverage__Last_Name__c = ‘Last Name’;
oMemberPlan.medicalcoverage__Birth_Date__c = Date.parse('9/7/1986') ;
oMemberPlan.MemberNumber = ‘Member#’;
oMemberPlan.medicalcoverage__Payer_Name__c = ‘Payer Name’;
oMemberPlan.medicalcoverage__Payer_Id__c = ‘Payer ID’;
oMemberPlan.medicalcoverage__NPI__c = '1578505947';
oMemberPlan.MemberId = ‘Member Id’;
oMemberPlan.medicalcoverage__API_Status__c = 'Processing';
oMemberPlan.medicalcoverage__As_of_Date__c = System.today();
oMemberPlan.medicalcoverage__PrimarySecondaryTertiary__c = 'Primary';
insert oMemberPlan;
How to Refresh Member Plan Record
Apex Class - InvocableMemberPlanRefresh
Method - runMemberPlanRefresh
Parameter - List<Id> lstMemberPlanRecordId
Please make sure that you update the BELOW 2 FIELDS ON THE MEMBER PLAN before calling the class to refresh
medicalcoverage__As_of_Date__c - As of date on the Member Plan to today’s date (else it will update the Member Plan with the existing As of Date) -
medicalcoverage__Coverage_ID__c – set Coverage ID to null