We completed a decision model that provides a solution for DMCommunity April-2024 Challenge “Using Lookup Tables in Decision Models“. This challenge deals with processing complex medical claims containing many medical procedures and diagnoses. The decision model is supposed to find incompatible procedures and diagnoses using large CSV files that may contain hundreds of thousands of records. There were two major requirements:

1. Maintaining standard lists separately from the decision models
2. High performance: handling millions of claims per day.

Our decision model demonstrates how to satisfy these requirements while representing the claim processing logic using simple decision tables oriented to business analysts.