Procella HelpdeskProcella Criteria load
- The file should be a tab delimited csv file
- Criteria batch file will be mainly driven by using Record type. Every row will start with a record type and followed by data. We have 2 record types. Based on the record type, system will automatically identify whether the particular row is condition or expression.
Records types:
- COND - Short for Condition. This record type defines whether its an include condition or exclude condition
Example -
COND<TAB>I
- EXPR - Short for Expression. This record type holds all the expressions need to be included. It contains totally 6 values separated by TAB.
Example -
EXPR<TAB>leftparanthesis<TAB>attribute<TAB>operator<TAB>value<TAB>rightparanthesis<TAB>conditionaloperator
EXPR ( Claim.claimEndDate = 20220822 ) ||
File Naming Conventions:
Criteria batch file name contains all the criteria information. The file name should follow a specified format.
<pbmid>_<jobtype>_<criteriaid>_<statusCode>_<effectivestartdate>_<effectiveenddate>.csv
Example -
FASTPAYRX_CRITERIA_219_A_20220228_99991231.csv
- pbmid - This is user entered PBM ID. This can be grabbed from Client Services → PBM screen
jobtype - CRITERIA
- criteriaid - Criteria ID will be available in the Criteria itself. Note : Criteria must be created before loading.
- statusCode - Allowed values - A or D
A activates the criteria
D will save the criteria as draft
- effectivestartdate - Date format in yyyyMMdd
- effectiveendate - Date format in yyyyMMdd
Segments of EXPR Record
| Segments | Description | Value | Mandatory |
| EXPR | Short for expression. Every expression line should start with EXPR | EXPR | Yes |
| Left Parenthesis | Left Parenthesis | ( | Situational based on the expression line |
| Domain.Attribute | Attribute under evaluation. Domain could be Drug, Claim, Member, Provider etc | Refer the attached document for how the domain.attribute to be provided in the file | Yes |
| Operator | The operator in the expression | Refer the attached document for supported operators for each attibute | Yes |
| Value | The value to which it has to be evaluated. Value should meet the formatting requirements as established in the UI. | Depends on the Attribute | Yes |
| Right Parenthesis | Right Parenthesis | ) | Situational based on how you build your expression |
| Conditional Operator | This is where you define how you combine multiple expressions For eg COND I EXPR Drug.NDC11 = 00310737020 || | && || | Situational based on your expression |