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Get latest MCO

Determine the worker's currently effective managed-care organization (MCO) location for a claim.

Field Value
Operation ID OP-SD-05
Trigger Caller requests the latest MCO for a claim.
Inputs Claim id
Outputs McoLocation (possibly empty)
Primary components CCClaimApiService.GetLatestMco
Entry point Data/SAIF.Data/Queries/Claims/CCClaimApiService.cs

Steps

  1. Call IClaimDataApiClient.GetGuidewireClaimDataMCO(claimId).

    Origin: This step delegates to ClaimDataApiClient.GetGuidewireClaimDataMCO, implemented in SAIF.Data.Guidewire, which issues a cached GET of claims/{claimId}/mco and returns the single current MCO for the claim.

  2. Keep entries whose effective date is on or before today and whose expiration is today or later, or DateTime.MinValue (SD-BR-012).
  3. Order by effective date, newest first, and take the first entry; upper-case the plan id. If none match, return an empty McoLocation (SD-BR-012).

Process flow

The following diagram visualizes this operation's control flow.

flowchart TD
    Start([Caller requests the latest MCO for a claim.]) --> S1["`CCClaimApiService.GetLatestMco`"]
    S1 --> S2{"Rules satisfied?"}
    S2 -->|Yes| EndOk([Result returned])
    S2 -->|No| EndErr([Exception / empty result])

Failure and edge-case behavior

  • No matching entries: returns an empty McoLocation rather than null.

Sources

  • Data/SAIF.Data/Queries/Claims/CCClaimApiService.cs