PSP Benefits Verification

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Architecture Diagram

resources/psp-benefit-verification-api-impl_ArchitectureDiagram_Image_1-aafc9ce2-e392-4bd8-af7f-d71cb60e94d2.png

SNoDescription
1The benefit E-verify request (Care Benefit Verification Request) is triggered by a patient services representative in the Pharma org.
2The request is received by the Mulesoft benefit verification application.
3The benefit verification request is transformed to an FHIR CARIN Rtpbc RequestBundle.
4The request is sent to the clearinghouse (CH) or payer system via a generic FHIR client.
5The clearinghouse or payer processes the request asynchronously and sends a request received acknowledgment as a response.
6The application sends back the request received acknowledgment.
7The third-party clearinghouse or payer sends an FHIR CARIN Rtpbc ClaimResponse for the pharmacy benefit verification request.
8The application transforms the response to update data in the Salesforce org via an sObject API call.
9The application updates the Coverage Benefit information in the Salesforce org.
10The application returns a success or error response to the clearinghouse or payer.

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TypeApplication
OrganizationMuleSoft
Published by
MuleSoft Organization
Published onFeb 13, 2025
Asset overview
Industries CloudLife Sciences
Custom fields

Asset versions for 1.0.x

Asset versions
VersionActions
1.0.0