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Understand Claim Workflow Rules Runtime

Understand Claim Workflow Rules Runtime

The runtime phase is initiated automatically to evaluate a specific claim against the rules configured during design time.

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  1. The process begins when an API call is made to the Rule Evaluation API, specifying the claim and the rule to be evaluated.
  2. The API's first step is to call the Context Service to get the context definition of the object (Claim). This service retrieves the complete, hydrated context definition for the claim object, gathering all necessary data points required for evaluation.
  3. The hydrated claim data, along with the rule definition, is passed to the Business Rules Engine (BRE). The BRE performs the core evaluation, comparing the claim's data against the rule's logic and returning an output (e.g. true or false).
  4. Based on the evaluation output from the BRE, the associated actions are enqueued and executed by the Dynamic Revenue Orchestrator (DRO). When a rule condition is evaluated as true or false, specific actions are triggered.
 
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