Create a Rule

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At a Glance

When your practice keeps correcting the same field on the same kind of claim, that correction belongs in a rule. This guide covers the three ways to build one: describe it in plain language and let Athelas Assistant draft it, clone a rule that is already close to what you need, or build each condition and action yourself. For how to read, search, edit, and dry run the rules you already have, see The Rules Tab.

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Open the Rule Builder

Go to Automations → Rules, open the rule engine you want to add to, then click + New Rule in the top right. The engine you start from sets the new rule’s Rule Type, and that field is fixed once the builder opens. To build a rule of a different type, start from that engine’s tab instead.

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Three Ways to Build a Rule

The Create New Rule screen asks what you want to build and gives you three routes to the same builder.

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What Every Rule Contains

Whichever route you take, you land in the same builder and fill in the same parts:

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Build a Rule with AI

Instead of assembling conditions field by field, type what you want into the prompt box and click Send. For example, you could describe:

• “Block claims from submitting if the rendering provider’s NPI is missing.”
• “Flag any claim over $5,000 for manual review before it goes out.”
• “When a claim is denied for a missing modifier, automatically route it to the Appeals queue.”

Your description runs through a few checks before anything reaches the builder:

• Everything is verified to exist. Every condition, data point, and action you ask for is checked against what the system actually supports. If something is not available, you are told rather than handed an approximation.
• Ambiguity gets resolved. The assistant picks the condition type that matches what you actually mean, for example whether a value simply needs to be present or needs to occur in combination with something else.
• Scope stays where you put it. Conditions and actions stay within the object type they belong to, so a rule cannot quietly reach beyond what you asked it to touch.

Review and adjust the draft before you submit it. AI-drafted rules go through the same approval step as rules you build by hand.

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Build a Rule by Cloning

Choose Clone a rule to start from something that already works. You can point at the source rule two ways:

• By ID. Find the rule’s ID in the top left of the rule you want to copy, then select it from Select Rule ID.
• By URL. Copy the rule’s URL from your browser, or use the link button at the top of the rule, then paste it into Rule URL.

Either way, the panel previews the source rule’s full Structure, its trigger, conditions, and actions, so you can confirm you grabbed the right one. Click Continue and the clone opens as a new draft with those conditions and actions already filled in. Give it its own ID and description, change what differs, then save.

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Build a Rule Manually

Choose Create a rule manually to work through the builder section by section. To build a rule from scratch:

1. Fill in General: give the rule an ID, pick the Site it applies to, and set a Priority. Rule Type is already filled in from the engine you started in, and State starts as Draft.
2. Write the Description: the Reason for rule and the Explanation of rule. Both are required.
3. Add your Conditions. Use + Condition for a single test and + Group for a nested set, then set the operator on each level to ALL or ANY to control how they combine.
4. Add your Actions with + Action. Add more than one if the same conditions should produce several outcomes.
5. Click Save. The rule is saved as a Draft.

Note: Prefer to work in code? Click JSON to paste conditions and actions in directly instead of setting each field one at a time.

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Before Your Rule Goes Live

Saving a rule does not activate it. Two things happen first, and both are worth using deliberately:

1. Dry run it. Replay the rule against real records to see which conditions match and exactly which fields it would change, without touching anything. See Dry Running a Rule.
2. Send it for approval. Every rule, whether you drafted it with AI or built it by hand, goes through an approval step before it takes effect.

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FAQ

Does my rule start working as soon as I save it?

No. New rules save in Draft, and every rule goes through an approval step before it takes effect. Dry run it first so you know what it would do, then send it for approval.

Can one rule do more than one thing?

Yes. A single rule can trigger several actions off the same set of conditions. Use + Action to add each one rather than building a separate rule per action, which keeps the conditions in a single place if they ever need to change.

I described a rule and the assistant said a condition is not available. Why?

Every condition, data point, and action you describe is checked against what the system actually supports before it reaches the builder. When something is not available, you are told outright instead of being handed a close-enough approximation that would quietly behave differently from what you asked for.Rephrase using data the rule can see, or clone an existing rule that already tests something similar to find the supported equivalent.

Do I really have to write both description fields?

Yes, Reason for rule and Explanation of rule are both required. The reason captures why the rule exists and the explanation captures what it does in practice. Together they are what makes a rule readable to the next person who opens it, including you in six months.

Can I paste in JSON instead of building each field?

Yes. Click JSON in the builder to enter conditions and actions directly. It is the fastest route when you already have the logic written out, or when you are recreating a rule from another site.