Eligibility Checker Automation - Service Cloud
- Sheni Singhal
Analytics
Non 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 | cloudmaven_ec2__First_Name__c |
Last Name | cloudmaven_ec2__Last_Name__c |
Birth Date | cloudmaven_ec2__Birth_Date__c |
Member Number | cloudmaven_ec2__MemberNumber__c |
Payer Name | cloudmaven_ec2__Payer_Name__c |
Payer Id | cloudmaven_ec2__Payer_Id__c |
NPI | cloudmaven_ec2__NPI__c |
API Status | cloudmaven_ec2__API_Status__c |
As Of Date | cloudmaven_ec2__As_of_Date__c |
Member | cloudmaven_ec2__MemberId__c |
Sample Apex Code Snippet to Create a Member Plan Record
MemberPlan oMemberPlan = new MemberPlan();
oMemberPlan.Name = 'Primary-CIGNA(62308)';
oMemberPlan.cloudmaven_ec2__First_Name__c = ‘First Name’;
oMemberPlan.cloudmaven_ec2__Last_Name__c = ‘Last Name’;
oMemberPlan.cloudmaven_ec2__Birth_Date__c = Date.parse('9/7/1986') ;
oMemberPlan.cloudmaven_ec2__MemberNumber__c = ‘Member#’;
oMemberPlan.cloudmaven_ec2__Payer_Name__c = ‘Payer Name’;
oMemberPlan.cloudmaven_ec2__Payer_Id__c = ‘Payer ID’;
oMemberPlan.cloudmaven_ec2__NPI__c = '1578505947';
oMemberPlan.cloudmaven_ec2__MemberId__c = ‘Member Id’;
oMemberPlan.cloudmaven_ec2__API_Status__c = 'Processing';
oMemberPlan.cloudmaven_ec2__As_of_Date__c = System.today();
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
cloudmaven_ec2__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) -
cloudmaven_ec2__Coverage_ID__c – set Coverage ID to null