University Academic Program

Pega’s University Academic Program

Aarogya Registration
(Use Case)
University Academic Program

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Document Name: Aarogya Registration for Hospital and DayCare

Date: 01-May-2020
University Academic Program

Table of Contents

Contents
1 Aarogya Registration for Hospital and DayCare - No. of Hours 8 ............................................................................ 4
University Academic Program

1 Aarogya Registration for Hospital and DayCare - No. of Hours 8

Use Case ID UC-103 Version 1.0
Use case Name Aarogya Registration for Hospital and DayCare
Platform Pega 8.3 Time for completion 8 Hours
Details
Created By Mukesh Kumar Agrawal Last Updated By 25th May 2020
th
Date Created 25 May 2020 Last Revision Date
Concepts 1. Case Lifecycle
covered 2. Data Modelling
3. Data type
4. Correspondence
5. Service Level Agreement
6. Routing
7. Reporting
8. Data Transform
9. Data Pages
10. Styling of Application
Description AAROGYA is a registry of hospitals and medical day-care centres, in the health insurers and
Third Party Administrators (TPAs) network, created to benefit health insurance stakeholders.
 Each hospital/day-care centre is identified with a 13-digit globally unique GS1 identifier
(GLN – Global Location Number) along with geo-coding of their address, which prevents
the duplicate listing of the same centre/hospital, leading to faster processing of
insurance claims.
 All network hospitals and hospitals involved in cashless reimbursement claims or those
that wish to provide this facility, have to be registered on AAROGYA.
 As a single source of reliable, updated and authenticated information on the location of
a hospital and medical day-care centre, the registry also provides information on
contact details, treatments, and costs of the hospital/centre.
Benefits of the AAROGYA registry include:
 Ensures each hospital/ medical day-care centre is listed only once, which helps with
processing insurance claims faster
 Brings authenticity and greater visibility of the hospitals and healthcare facilities across
the country
 Facilitates fast, reliable and relevant analytical reporting at national, region and state
level on geography-based trends, patterns of disease occurrence, cost patterns etc.
 Electronic exchange of medical records between hospitals and insurance companies
seamlessly in future
 Prevents insurance frauds due to fake hospital information
 Facilitates hospitals to communicate address or contact information changes in a
matter of click to all stakeholders
AAROGYA is accessed by various stakeholders including healthcare insurance companies,
government bodies, regulators and the general public.

● Prepare a Registration process for AAROGYA

● Prepare a Renewal process for AAROGYA

Requirements :
1. Maintain Data for Hospitals using Registration
2. Validate the Hospital Details
3. Collect Feedback from Insurers and TPAs
4. Payment Integration with Leading Payment Providers
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Case Type Registration process for AAROGYA

1. Search the hospitals

2. Click on Registration and provide the details
3. Get Feedback from TPA/Insurers and Validate

4. Payment
5. Final Registration

Exception Scenarios
1. Invalid Details
2. Invalid Documents
3. Payment Failure

Renewal process for AAROGYA

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Data Model 1. Hospitals – To capture the Complete details for Hospitals – Basic, Identity
2. Insurer – Basic Information about the Insurer registered with IRDA
3. TPA - Basic Information about the TPA registered with IRDA
4. PinCode – Pincode master data related to city and State
5. Empanelment Details – Feedback and Level received for Hospitals from Each Insurer and TPA

Correspondenc Registration Confirmation

es

Invalid Details

Invalid Documents
University Academic Program

Payment

Final Email

Renewal Email

SLA Complete Registration Process should be 5 days.

Validation – 3 days , Reminder to Operator
Payment – 1 day , Reminder to Customer
OTP Verification – 2 hours / Deadline 3 hours , OTP need to be regenerated again after
deadline.
Invalid document – 2 days , Reminder to Customer
Invalid details – 2 days , Reminder to Customer
Payment failure – 24 hours , , Reminder to Customer

All deadline can be added as 1 day extra excepts OTP.

Actors Customer, Operators, Government Bodies , Regulator, Guest

Mock up
screens Search and Results
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University Academic Program
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Payment Page

Trigger Customer should initiate the search for hospitals and start the registration or renewal process.
Preconditions Create sample operators for the application
Prepare Sample data for Hospitals, TPAs, Insurers
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Post conditions Application should address all Validations on data.

Normal Flow

Alternate Flows 1. Invalid Details

2. Invalid Documents
3. Payment Failure
Exceptions NA
Includes Data types with local source to be created wherever necessary.
Sample data for Hospitals, TPAs, Insurers,PinCode,Network Hospitals
Frequency of NA
Use
Special Layouts should be neat . Consistent formatting and mixins can be used.
Requirements
Future Enhance the application to be used in rest of the world.
Requirements Web Mashup in Company Site
Service development to provide the Details about Registered Hospitals
Assumptions NA
Notes and NA
Issues
Acceptance Guardrail score should be greater than 90. Feedback parameters should capture from 1 to 10
Criteria for each question. Average feedback should be > 5 to schedule the follow-up call.
(scenarios for Products display should be applied on repeating Dynamic Layout.
Unit Testing)
Sample Data

IRDA-Data-TPA_201 IRDA-Data-PinCode IRDA-Data-Insurer_ IRDA-Data-Hospital Netwrok

71017T052133.433 GMT.csv 20171017T052101.559
_20171017T051841.534 GMT.csv s_20171017T052042.059
GMT.csv Hospitals.csv
GMT.csv