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Hi Sigitas,
We have analyzed your enhancement request and believe it is currently supported without the need of replicating the entitlement ruleset in verification ruleset.
Verifications are evaluated when evidence is maintained; creation or modification (depending on configuration specified), which you mentioned. However verifications are also evaluated on the creation of a product delivery case, which you did not mention and which we believe supports this enhancement request.
Evaluating verifications on creation of a product delivery case allows for the system to determine if there are verifications for the product delivery on any common evidence within the Integrated Case. Within Insurance Affordability, the product delivery case is only created based on entitlement and therefore on creation of the product delivery it will evaluate verifications. This therefore allows for the separation of entitlement calculations from the verification conditions.
I will now close this ticket based on the above response.
Please contact us if there are other needs that we have not considered here.
Thank you,
Eloise O'Riordan, Cúram SPM Offering Management team
Hi Sigitas,
We have analyzed your enhancement request and believe it is currently supported without the need of replicating the entitlement ruleset in verification ruleset.
Verifications are evaluated when evidence is maintained; creation or modification (depending on configuration specified), which you mentioned. However verifications are also evaluated on the creation of a product delivery case, which you did not mention and which we believe supports this enhancement request.
Evaluating verifications on creation of a product delivery case allows for the system to determine if there are verifications for the product delivery on any common evidence within the Integrated Case. Within Insurance Affordability, the product delivery case is only created based on entitlement and therefore on creation of the product delivery it will evaluate verifications. This therefore allows for the separation of entitlement calculations from the verification conditions.
Are there other needs that we have not considered here? Or can I please close this ticket as delivered?
Thank you,
Eloise O'Riordan, Cúram SPM Offering Management team
Hi Nikita,
Thank you for providing this information.
We will look into this further and get back to you shortly.
Thank you,
Eloise O'Riordan, Cúram SPM Offering Management team
The verificaiton engine is invoked when evidences are saved. Say we have a client who is on Insurance Assistance. The client reports that his new income is $10,000, and we make that evidence change on an Integrated Case.
In order for us to raise a verification appropriately (to know which conditional verificaiton rules to apply), we need to know what program the client will be eligible for - Insurance Assistance, Medical Assistance, or SBHP.
In order to figure that out, we pretty much have to replicate the entire eligibility rule sets for these programs in the conditional verification rules using *verData rules such that In Edit rather than only Active evidences are used in the eligibility determination. This greatly increases maintenance costs.
Hi Sigitas,
In order to evaluate your request, we require that you provide more detail on the business scenario you are trying to support so that we can fully understand your requirements.
If we do not receive this information within 30 days, this request will be closed.
Thank you,
Eloise O'Riordan, Cúram SPM Offering Management team
Hi Sigitas,
Thank you for your enhancement request.
We require some further analysis to determine whether or not this enhancement can be considered in a future release.
I will provide another response when our investigation is complete.
Thank you,
Eloise O'Riordan, Cúram SPM Offering Management team