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Status Not under consideration
Categories Social Program Management Platform
Created by Guest
Created on Apr 14, 2020

RELATED IDEAS

Evidence is not being read into the rules/decisions and Incorrect start date for coverage when person added to a case

1) Problem: Evidence is not being read into the rules/decisions
Impact: possible incorrect coverage
Resolution: The rules were unable to read future dated evidence into the rules when the received date and start date were not the exact same date. In addition, future end dated evidence was being pulled back to end in the last day of the prior month to the end date. In adition, overlapping evidence was not working properly either. For the future dated evidence to start in the future, MO have changed the curam OOTB timeline logic to now do comparisons on the received date and the start date and select the later date as the start date of the evidence succession sets. This is an outstanding issue with how curam builds timeline attributes when the dates are different, and MO have overridden the curam behavior to now function how it is supposed to be functioning. So that MEDES system can pull in future start dated evidence with different start date and received dates.


2) Problem: Incorrect start date for coverage when person added to a case
Impact: coverage should be from the 1st of the month
Resolution: The evidence propagation, which determines when to bring evidence into the rules, was always using the latest of the received date or the start date of the evidence. This meant any new evidence could not cover back to the first of the month, unless everything is pushed back, which didn't always work. MO have changed the propagation rules so that now the latest of the received date or start date is still used to determine when to bring the evidence into the rules, but when this date is calculated it is now changed to be the first of that month. So, if the received date is 8/15 and the start date is 7/15, the latest date is 8/15 and it is now pushed back to the first of that month, 8/1, to make the evidence effective for the entire month so the eligibility push back to the 1st of the month will work. This change effects when the evidence is pulled into the rules, but any start dates used in the eligibility still apply.

Customer Name Missouri
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  • Guest
    Reply
    |     Oct 7, 2020

    Hi Maribeth,
    We have not received the additional information we previously requested from you that would allow us to fully understand and evaluate your enhancement request. Since we have not received the information within the 30 day timeframe, we are closing this request.

    If you are able to provide the additional information in the future, please open a new enhancement request and we will be glad to review. We do appreciate the time you take to share your ideas with us and utilize your inputs to improve our product offering.

    Thank you,
    Shane McFadden, SPM Offering Management team
    You can find more information on the request process here.

  • Guest
    Reply
    |     Aug 26, 2020

    Hi Maribeth,

    We have reviewed your enhancement suggestion and require more information to properly understand the issue and the business scenario you are trying to support.

    The issue described for income evidence could not be reproduced based on the scenario provided.
    OOTB, there is a validation preventing future start dates on income. But when that validation was removed, it was observed that income was still successfully propagated to rules (where the received and start date were different and where the start date was a future date). This was verified via SessionDoc.

    1. It was noted that some changes/fixes have been made to this general area which may have addressed some of the issues reported e.g. https://www.ibm.com/support/pages/apar/PO07685. Could you please let us know if the scenarios been retested since the recent upgrade from v6 to v7?

    2. Assuming it is still an issue in v7, could an updated scenario be provided to enable this issue to be reproduced OOTB, please?

    3. Could you let us know what the value of curam.hcr.effectiveDate is in the MO system? This property relates to how the propagation of evidence into rules will work in HCR. OOTB it is set to 'YES' by default.

    4. Could you please provide the fully qualified name of the static class that was changed? There are a number of classes related to rules propagation in HCR and so we would like to be absolutely certain.

    5. Additionally, if the code that was changed can be provided, that would greatly assist us in processing your request.

    Please provide the requested information within 30 days so we may proceed with our evaluation. If we do not hear from you within that timeframe we will have to close the request due to insufficient information.

    Thank you,
    Shane McFadden, SPM Offering Management team
    You can find more information on the request process here.

  • Guest
    Reply
    |     Apr 15, 2020

    Hi Maribeth,

    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,
    Shane McFadden, Cúram SPM Product Management team