hardDesignCase StudySeniorStaff
You are building the payer side. How do you configure benefits so a plan change does not need a code release?
6 min readUpdated 2026-08-15
Answer
Short answer
Separate the adjudication engine from effective-dated, immutably versioned configuration, resolve config by date of service rather than by today, hold accumulators as a reversible ledger of contributions, adjust decisions by replacement rather than edit, and release config through a replay harness.
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Likely follow-ups
- A fee schedule was loaded with the wrong effective date and eight thousand claims paid on it. Walk me through the correction.
- Two claims for the same member arrive out of order and both would consume the last of the deductible. What does your design do?
- How would you let a business analyst author benefit rules without effectively giving them an untested programming language?
- What would you replay a configuration change against, and what does a diff have to show before you would release it?
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