SAIF.Data operations and processes

This page is the operation catalog and cross-operation hub for this library. Each operation's detailed, step-by-step logic lives in its own page under operations/.

Operation catalog

Operation	Intent	Trigger	Inputs	Outputs	Rules	Tables	SQL
Register data clients	Register the Guidewire data-client configuration, HTTP clients, and cache infrastructure in the DI container.	Host application calls AddDataClients during startup.	SystemType, systemName, optional configure action	Registered IDataClientConfiguration singleton, 7 API clients, cache infrastructure	SD-BR-001, SD-BR-002	None	None
Authenticated/cached HTTP GET	Provide a base HTTP client with lazy construction, credential resolution, and optional response caching for Guidewire API calls.	A derived client class issues a GET or cached GET/POST call.	Request URL, optional request body, UseCache/ensureSuccess flags	Deserialized response of type T, or a cached copy	SD-BR-002, SD-BR-003, SD-BR-004	None	None
Get e-bill EOB extract	Retrieve the e-bill explanation-of-benefits extract from the Medical Billing API for a given clearinghouse.	Caller requests an EOB extract for a clearinghouse code.	Clearinghouse code, row limit	Deserialized EOB extract result	SD-BR-003, SD-BR-004	None	None
Validate claim / get claim	Validate a claim's existence and retrieve claim, worker, and worker-address data from the Guidewire CC Claim Data API.	Caller validates or retrieves a claim, worker, or worker address by id.	Claim id, claim number, worker id	Claim/worker data, or null/false	SD-BR-010, SD-BR-011	None	None
Get latest MCO	Determine the worker's currently effective managed-care organization (MCO) location for a claim.	Caller requests the latest MCO for a claim.	Claim id	McoLocation (possibly empty)	SD-BR-012	None	None
Bill queue processing	Retrieve the next claim bill from the processing queue, or restore a bill to the queue.	Bill-entry task processing requests the next queued bill, or restores one.	Queue flag, task id	Bill data with return/image codes, or a restore result code	SD-BR-013	None	None
RCT policy selection	Retrieve RCT (rate-change-tracking) policy selection data for a given date.	Caller requests policy selection for a flag and date.	Flag, date	Deserialized policy selection result	None	None	None
Claim security override check	Determine whether an employee has a security override permitting access to a restricted claim.	Access check for an employee against a claim.	Claim id, employee id	bool	SD-BR-020	CL_SECURITY_OVERRIDE	SQL-073
Recoverable overpayment balance	Compute the total recoverable overpayment balance outstanding for a worker.	Caller requests a worker's recoverable overpayment balance.	Worker id	decimal	SD-BR-021	CL_OVERPAYMENT, CL_CLAIM_PERSON	SQL-190
Bill audit evaluation	Evaluate audited bill services to determine nurse-review requirements, duplicate/physical-medicine counts, and service date ranges.	Bill audit workflow evaluates a bill's audited services.	Bill id, service collection	bool / int counts / service list	SD-BR-030, SD-BR-031, SD-BR-032	CBP_AUDIT, CBP_BILL, CBP_NATIONAL_DRUG, CBP_SERVICE_CODE, CBP_AUDITED_SERVICE	SQL-013, SQL-014, SQL-015, SQL-016, SQL-017, SQL-018
Audit note concurrency check	Verify that an audit note can be saved without an optimistic-concurrency conflict.	Caller attempts to save an audit note.	Note id, update number	bool	SD-BR-033	CBP_NOTE, CBP_BILL, CBP_NOTE_TYPE_CODE, CBP_NOTE_CATEGORY_CODE	SQL-004, SQL-005, SQL-006, SQL-007, SQL-008, SQL-009
Bill queries	Query bill records, entry-source classification, allowed amounts, and non-expired service codes.	Bill-related read operations.	Bill id, service code	Bill/service data	SD-BR-034, SD-BR-035, SD-BR-036	CBP_BILL, CBP_BILL_TYPE_CODE, CBP_BILL_STATUS_CODE, CBP_BILL_STATUS, CBP_BILL_ENTRY_SOURCE_CODE	SQL-024, SQL-025, SQL-026, SQL-027, SQL-028, SQL-029
Attending physician resolution	Resolve the attending physician's location for a claim, combining physician and facility contacts.	Caller requests the attending physician location for a claim.	Claim id	Location, or throws	SD-BR-040	PROVIDER_LOCATION	SQL-057
Claim status and compensability	Resolve claim status, compensability, original acceptance decision, and legacy MCO enrollment date; reject retired WCIS activity queries.	Caller requests claim status/compensability/acceptance data.	Claim id	Status/code data, or NotImplementedException	SD-BR-041, SD-BR-042, SD-BR-043, SD-BR-044, SD-BR-045	LPT_CLAIM_CROSS_REFERENCE, CL_CLAIM_STATUS_ACTIVITY, CL_CLAIM_PERSON_ADDRESS, CL_CLAIM_REQUEST_DECISION	SQL-056, SQL-058, SQL-059, SQL-061, SQL-062, SQL-063
Claim financial transactions	Retrieve and translate a claim's time-loss financial transactions from the Guidewire financials API.	Caller requests financial transactions for a claim.	Claim id	Filtered/translated financial transaction list	SD-BR-046, SD-BR-047, SD-BR-048	None	None
Claim data-quality queries	Identify claims with data-quality issues such as a missing tax id or outstanding reserves.	Data-quality/reporting queries.	None (batch scan)	Claim lists	SD-BR-049	CL_INJURY_CLAIM, CL_CLAIM_PERSON	SQL-060
E-bill processing queries	Support e-bill lifecycle queries: status/assignment classification, clearinghouse response-file selection, compound-drug flagging, batch classification, zero-pay EOB candidates, DRG lookup, and active clearinghouse resolution.	E-bill processing workflow steps.	Bill/EOB/batch identifiers	Bill/EOB/batch data, flags set	SD-BR-050, SD-BR-051, SD-BR-052, SD-BR-053, SD-BR-054, SD-BR-055, SD-BR-056	EBILL_ADDRESS, EBILL_ADDRESS_TYPE_CODE, EBILL_BATCH, EBILL_ADDRESS_OVERRIDE, EBILL_CLEARINGHOUSE	SQL-074, SQL-075, SQL-076, SQL-077, SQL-078, SQL-079
Legal case queries	Resolve a claim id for a legal case, resolve preferred employee names, and retrieve financial transactions by invoice number.	Legal case processing workflow.	Case number(s), invoice number	Claim id, name, payment	SD-BR-060, SD-BR-061	LEGAL_CASE, CASE_COST, LEGAL_BILL, SUBPOENA, APPEAL	SQL-152, SQL-153, SQL-154, SQL-155, SQL-156, SQL-157
Location lookups	Resolve location and contact records using fixed location codes and contact-type precedence.	Location resolution requests.	Policy/claim id, state	Location data	SD-BR-062	LOCATION, CONTACT, OFFICE_CODE	SQL-167, SQL-168, SQL-169, SQL-170, SQL-171, SQL-172
Output document queries	Query policy output documents by status, category, agency visibility, and parent/child release state.	Document retrieval requests from agency/policy workflows.	Policy id, category, document id	Document list, or throws	SD-BR-070, SD-BR-071, SD-BR-072, SD-BR-073, SD-BR-074, SD-BR-075	document_status_code, POLICY, batch_process_log, policy_output_document, output_document_type_code	SQL-181, SQL-182, SQL-183, SQL-184, SQL-185, SQL-186
Provider queries	Query provider identity, relationship, address, location, and MCO-window data used across bill and claim workflows.	Provider lookup or update requests.	Provider id, bill id, MCO id	Provider data, updated audit stamp, bool	SD-BR-080, SD-BR-081, SD-BR-082, SD-BR-083	PROVIDER_ADDRESS, PROVIDER, PROVIDER_TAX_ID, PROVIDER_LOCATION	SQL-200, SQL-201, SQL-202, SQL-203, SQL-204, SQL-205
Other query providers	Support certificate-holder search, task lookup, worker/support-order queries, report/payment classification, and Medicare beneficiary history matching.	Miscellaneous read queries across certificate, task, worker, report, payment, and Medicare domains.	Search terms, worker id, code values	Filtered lists, counts, bool	SD-BR-090, SD-BR-091, SD-BR-092, SD-BR-093, SD-BR-094, SD-BR-095	LOCATION_VERIFICATION_REQUEST, ADDRESS_VERIFICATION_REQUEST, VERIFIED_ADDRESS, CERTIFICATE_HOLDER	SQL-001, SQL-002, SQL-003, SQL-051, SQL-052, SQL-053
Model helper operations	Provide in-memory model helper behavior: child id sequencing, financial-transaction validation, subpoena classification, cost-category lookup, and show-only enum conversion.	Callers construct or classify in-memory domain model instances.	Model instances/fields	Mutated model state, classification results	SD-BR-100, SD-BR-101, SD-BR-102, SD-BR-103, SD-BR-104	None	None

Process flow diagram

The following diagram visualizes the primary operational flow across operations.

flowchart TD
    Start([Caller request]) --> Register[Register data clients]
    Register --> HttpCall[Authenticated/cached HTTP GET]
    HttpCall --> Decision{"Guidewire API or local ORM query?"}
    Decision -->|Guidewire API| ClaimOps[Claim/legal/e-bill API operations]
    Decision -->|Local ORM| QueryOps[Query-provider read operations]
    ClaimOps --> EndOk([Data returned to caller])
    QueryOps --> EndOk

Database interactions

The following table summarizes which operations read from or write to the database. Per-step SQL and table citations live in each operation's detail page under operations/.

Operation	SQL	Tables	Type
Claim security override check	SQL-073	CL_SECURITY_OVERRIDE	Read/Write*
Recoverable overpayment balance	SQL-190	CL_OVERPAYMENT, CL_CLAIM_PERSON	Read/Write*
Bill audit evaluation	SQL-013, SQL-014, SQL-015, SQL-016, SQL-017, SQL-018	CBP_AUDIT, CBP_BILL, CBP_NATIONAL_DRUG, CBP_SERVICE_CODE, CBP_AUDITED_SERVICE	Read/Write*
Audit note concurrency check	SQL-004, SQL-005, SQL-006, SQL-007, SQL-008, SQL-009	CBP_NOTE, CBP_BILL, CBP_NOTE_TYPE_CODE, CBP_NOTE_CATEGORY_CODE	Read/Write*
Bill queries	SQL-024, SQL-025, SQL-026, SQL-027, SQL-028, SQL-029	CBP_BILL, CBP_BILL_TYPE_CODE, CBP_BILL_STATUS_CODE, CBP_BILL_STATUS, CBP_BILL_ENTRY_SOURCE_CODE	Read/Write*
Attending physician resolution	SQL-057	PROVIDER_LOCATION	Read/Write*
Claim status and compensability	SQL-056, SQL-058, SQL-059, SQL-061, SQL-062, SQL-063	LPT_CLAIM_CROSS_REFERENCE, CL_CLAIM_STATUS_ACTIVITY, CL_CLAIM_PERSON_ADDRESS, CL_CLAIM_REQUEST_DECISION	Read/Write*
Claim data-quality queries	SQL-060	CL_INJURY_CLAIM, CL_CLAIM_PERSON	Read/Write*
E-bill processing queries	SQL-074, SQL-075, SQL-076, SQL-077, SQL-078, SQL-079	EBILL_ADDRESS, EBILL_ADDRESS_TYPE_CODE, EBILL_BATCH, EBILL_ADDRESS_OVERRIDE, EBILL_CLEARINGHOUSE	Read/Write*
Legal case queries	SQL-152, SQL-153, SQL-154, SQL-155, SQL-156, SQL-157	LEGAL_CASE, CASE_COST, LEGAL_BILL, SUBPOENA, APPEAL	Read/Write*
Location lookups	SQL-167, SQL-168, SQL-169, SQL-170, SQL-171, SQL-172	LOCATION, CONTACT, OFFICE_CODE	Read/Write*
Output document queries	SQL-181, SQL-182, SQL-183, SQL-184, SQL-185, SQL-186	document_status_code, POLICY, batch_process_log, policy_output_document, output_document_type_code	Read/Write*
Provider queries	SQL-200, SQL-201, SQL-202, SQL-203, SQL-204, SQL-205	PROVIDER_ADDRESS, PROVIDER, PROVIDER_TAX_ID, PROVIDER_LOCATION	Read/Write*
Other query providers	SQL-001, SQL-002, SQL-003, SQL-051, SQL-052, SQL-053	LOCATION_VERIFICATION_REQUEST, ADDRESS_VERIFICATION_REQUEST, VERIFIED_ADDRESS, CERTIFICATE_HOLDER	Read/Write*

Failure and edge-case behavior

• Guidewire API calls (OP-SD-03 through OP-SD-07): non-success HTTP status codes generally throw or map to sentinel return codes rather than silently returning defaults; see each operation's detail page.
• ORM query providers (OP-SD-08 through OP-SD-22): absence of matching rows generally yields an empty collection, false, or a zero sum rather than an exception, except where noted (e.g. OP-SD-20 child-document release check).

Related documentation

• Index
• Overview
• Architecture
• Dependencies
• Configuration
• Business rules
• Security and authorization
• Database tables
• SQL catalog
• API reference

Sources

• Data/SAIF.Data/Configuration/ContainerBuilderExtensions.cs
• Data/SAIF.Data/Clients/HttpClientBase.cs
• Data/SAIF.Data/Queries/Claims/CCClaimApiService.cs