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1 | OSCIF_CPEE_Sprint_1 and 2.zip\Build 4 Deliverables | Build_4 Sprint 1 Acceptance_CCSE_CPE.docx | Thu Dec 7 15:13:22 2017 UTC |
2 | OSCIF_CPEE_Sprint_1 and 2.zip\Build 4 Deliverables | Build_4 Sprint 1 Acceptance_CCSE_CPE.docx | Thu Dec 7 18:44:15 2017 UTC |
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1 | Claims Pro cessing El igibility (CP&E) | |
2 | Build 4 S print 1 Ac ceptance F orm | |
3 | Teams 1 t hrough 3 | |
4 | CLIN 0008A N | |
5 | ||
6 | October 20 17 | |
7 | Version 0. 1 | |
8 | Department of Vetera ns Affairs | |
9 | Office of Informatio n and Tech nology (OI &T) | |
10 | ||
11 | Revision H istory | |
12 | Note: The revision h istory cyc le begins once chang es or enha ncements a re request ed after t he Accepta nce Criter ia Form ha s been bas elined. | |
13 | Creation D ate | |
14 | Version No . | |
15 | Descriptio n/Comments | |
16 | Author(s) | |
17 | Reviewer(s ) | |
18 | Review Typ e | |
19 | Issue Date | |
20 | 10/09/17 | |
21 | 0.1 | |
22 | Initial ve rsion | |
23 | Michael Sy nakiewicz | |
24 | Richard Ma rble | |
25 | Internal | |
26 | ||
27 | ||
28 | Table of C ontents | |
29 | 1.Sprint 1 - 09/28/1 7 – 10/10/ 171 | |
30 | 1.1.CP&E T eam 1 - De mo Schedul e 14 Stori es1 | |
31 | 1.1.1.Cind y Stiles 1 0 Stories1 | |
32 | 1.1.2.Jeff Edelston 1 Story2 | |
33 | 1.1.3.Larr y Goren 2 Stories3 | |
34 | 1.2.CP&E T eam 2 - De mo Schedul e 2 Storie s3 | |
35 | 1.2.1.Kath ryn Leyva 1 Story3 | |
36 | 1.2.2.Denn is Bricker 1 Story3 | |
37 | 1.3.CP&E T eam 3 - De mo Schedul e 2 Storie s4 | |
38 | 1.3.1.Shav kat Shamuk hamedov 1 Story4 | |
39 | List of Ta bles | |
40 | Table 1: S print 1 CP &E Team 1 – 13 Stori es1 | |
41 | Table 2: S print 1 CP &E Team 2 - 2 Storie s3 | |
42 | Table 3: S print 1 CP &E Team 3 - 1 Story4 | |
43 | ||
44 | ||
45 | Sprint 1 - 09/28/17 – 10/10/17 | |
46 | Note: The Demo Prese nters for CP&E Teams User Stor ies in Bui ld 4, Spri nt 1 is de picted bel ow for eac h table in crement pr oduct func tionality. | |
47 | CP&E Team 1 - Demo S chedule 14 Stories | |
48 | Cindy Stil es 10 Stor ies | |
49 | Table 1: S print 1 CP &E Team 1 – 13 Stori es | |
50 | Status | |
51 | Story # | |
52 | Rational | |
53 | Descriptio n | |
54 | Acceptance Criteria | |
55 | ||
56 | 005-069 | |
57 | RM# 937671 | |
58 | As the R&R VE I want to manual ly input t he Origina l PDI numb er and the Current P DI number on the Doc ument ID s creen (ref er to user story CP& E005-004) when I sel ect to reo pen a manu al EDI sub mission. | |
59 | The system allows th e user to manually i nput the O riginal an d Current PDI number on the Do cument ID screen whe n they reo pen a Manu al EDI sub mission. | |
60 | ||
61 | 005-071 | |
62 | RM# 937673 | |
63 | As a VE I want to se e the EE S creen Bill Invoice F requency C ode 5 TOS DME the Or iginal PDI and Curre nt PDI Cla im informa tion to fa cilitate a nalysis. | |
64 | Acceptance Criteria: If the T ype of Bil l Frequenc y Code is 5 the syst em display s the Orig inal PDI c laim infor mation and the Curre nt PDI cla im informa tion. | |
65 | ||
66 | 005-080* | |
67 | RM# 937681 | |
68 | As the R&R VE if I d id not ent er 15 digi ts in tota l in the O riginal or Current P DI field, the system will disp lay "PDI# must be 15 digits" w hen I sele ct to reop en a manua l EDI subm ission | |
69 | If the use r did not enter 15 d igits in t otal in th e Original or Curren t PDI fiel d, the sys tem will d isplay "PD I# must be 15 digits " when reo pening a m anual EDI submission . | |
70 | ||
71 | 005-073* | |
72 | RM# 937675 | |
73 | As the R&R VE I want to apply the PDI Bu siness Rul e that the first fou r digits r epresents the year, are greate r than or equal to 2 000, and a re not gre ater than the curren t year to manually e ntered Ori ginal and Current PD I numbers when I sel ect to reo pen a manu al EDI sub mission. | |
74 | Manually e ntered Ori ginal or C urrent PDI numbers' first four digits re present th e year, ar e greater than or eq ual to 200 0, and are not great er than th e current year when the user s elects to reopen a m anual EDI submission . | |
75 | ||
76 | 005-074* | |
77 | RM# 937676 | |
78 | As the R&R VE I want to apply the PDI Bu siness Rul e that the 5th, 6th, and 7th d igit repre sents the Julian day and must be 001 thr u 366 to m anually en tered Orig inal and C urrent PDI numbers w hen I sele ct to reop en a manua l EDI subm ission. | |
79 | Manually e ntered Ori ginal or C urrent PDI numbers' 5th, 6th, and 7th d igit repre sents the Julian day and must be 001 thr u 366 when the user selects to reopen a manual EDI submissio n. | |
80 | ||
81 | 005-075* | |
82 | RM# 937677 | |
83 | As the R&R VE I want to apply the PDI Bu siness Rul e that the 8th and 9 th digit r epresents the PDI Pr ogram Indi cator and must be 90 , 91, 92, or 97 to m anually en tered Orig inal and C urrent PDI numbers w hen I sele ct to reop en a manua l EDI subm ission. | |
84 | The manual ly entered Original or Current PDI numbe rs' 8th a nd 9th dig it represe nts the P DI Program Indicator and must be 90, 91, 92, or 97 when the user selec ts to reop en a manua l EDI subm ission. | |
85 | ||
86 | 005-076* | |
87 | RM# 937678 | |
88 | As the R&R VE I want to apply the PDI Bu siness Rul e that the 10th thro ugh 15th d igits are not system validated to manual ly entered Original and Curren t PDI numb ers when I select to reopen a manual EDI submissio n. | |
89 | The manual ly entered Original or Current PDI numbe rs' 10th t hrough 15t h digits a re not sys tem valida ted when t he user se lects to r eopen a ma nual EDI s ubmission. | |
90 | ||
91 | 005-077* | |
92 | RM# 937679 | |
93 | As the R&R VE I want to apply the PDI Bu siness Rul e that the Original PDI Number cannot ha ve been pr eviously r eopened t o manually entered O riginal an d Current PDI number s when I s elect to r eopen a ma nual EDI s ubmission. | |
94 | The manual ly entered Original PDI number cannot ha ve been pr eviously r eopened wh en the use r selects to reopen a manual E DI submiss ion. | |
95 | ||
96 | ||
97 | 005-079* | |
98 | RM# 937680 | |
99 | As the R&R VE I want the syste m to verif y all asso ciated cla ims are Co mplete for the Origi nal PDI nu mber enter ed on the Document I D Screen w hen I sele ct to reop en an EDI submission . | |
100 | The manual ly entered Original PDI number will have all assoc iated clai ms in a Co mplete sta tus when t he user se lects to r eopen a ma nual EDI s ubmission. | |
101 | ||
102 | 005-070 | |
103 | RM# 937672 | |
104 | As a R&R V E I would like the O riginal PD I and Curr ent PDI fi elds to re vert to Re ad Only on ce the num ber field is populat ed and I a dvance to the next s creen when I select to reopen a manual E DI submiss ion | |
105 | The Origin al PDI and Current P DI fields revert to Read Only once the n umber fiel d is popul ated and t he user ad vances to the next s creen when they sele ct to reop en a manua l EDI subm ission | |
106 | Jeff Edels ton 1 Stor y | |
107 | Status | |
108 | Story # | |
109 | Rational | |
110 | Descriptio n | |
111 | Acceptance Criteria | |
112 | ||
113 | 005-051 | |
114 | RM# 937657 | |
115 | As the VE I want the system to display a n error me ssage when an un-aut horized ro le attempt s to proce ss an EDI Reopen cla im | |
116 | The system will disp lay the ac curate err or message if a user without t he proper authorizat ion attemp ts to proc ess either a CHAMPVA ReOpen ED I claim, o r a Spina Bifida ReO pen EDI cl aim, or a Manual EDI claim. | |
117 | Larry Gore n 3 Storie s | |
118 | Status | |
119 | Story # | |
120 | Rational | |
121 | Descriptio n | |
122 | Acceptance Criteria | |
123 | ||
124 | 005-033 | |
125 | RM# 932451 | |
126 | As the VE I would li ke the sys tem to fro nt end rej ect a subm ission on receipt of a TOB FC 8 when the Original PDI Is Not Valid | |
127 | If Current PDI is no t validate d by user the system sends an alert, tha t identifi es the PDI as Curren t or Origi nal and co ntains the status co de, to sen d a Final CSTAT mess age. | |
128 | ||
129 | 005-038 | |
130 | RM# 932472 | |
131 | As the VE I would li ke the sys tem to kil l the orig inal PDI u pon receip t of a TOB FC 8 when the Origi nal PDI ha s Not Star ted Proces sing | |
132 | The system kills the Original PDI in the EDI Ready Queue and sends an alert, tha t identifi es the PDI as Curren t and cont ains the s tatus code , to send a Final CS TAT messag e. | |
133 | ||
134 | 005-039 | |
135 | RM# 937655 | |
136 | As the VE I would li ke the sys tem to fro nt end rej ect upon R eceipt of submission with a FC 6 | |
137 | The system performs a front ed it (reject ) for a TO B FC6 and sends Ackn owledgemen t CSTAT A7 :21:464. | |
138 | *Note: Som e User Sto ries were assigned t o Teams 2 and 3, but due to th e routine used with coding, th ose storie s were dem onstrated by Team 1 | |
139 | CP&E Team 2 - Demo S chedule 2 Stories | |
140 | Kathryn Le yva 1 Stor y | |
141 | Table 2: S print 1 CP &E Team 2 - 2 Storie s | |
142 | Status | |
143 | Story # | |
144 | Rational | |
145 | Descriptio n | |
146 | Acceptance Criteria | |
147 | ||
148 | 005-031 | |
149 | RM# 914733 | |
150 | As the VE I would li ke to trig ger the ba cking out of the ori ginal char ges for an EDI Corre cted Claim | |
151 | Once a use r inputs Y in respon se to the prompt ask ing if he/ she wants to continu e, the sys tem will n ot repeat the prompt and will back out t he amounts applied t o annual i ndividual and family deductibl es, catast rophic cap and previ ous paymen ts from th e original PDI submi ssion. | |
152 | Dennis Bri cker 1 Sto ry | |
153 | Status | |
154 | Story # | |
155 | Rational | |
156 | Descriptio n | |
157 | Acceptance Criteria | |
158 | ||
159 | 005-032 | |
160 | RM# 914735 | |
161 | As the VE I would li ke to trig ger the ba cking out of the ori ginal char ges for a Manual EDI Corrected Claim | |
162 | Once a use r inputs Y in respon se to the prompt ask ing if he/ she wants to continu e, the sys tem will n ot repeat the prompt and will back out t he amounts applied t o annual i ndividual and family deductibl es, catast rophic cap and previ ous paymen ts from th e original PDI submi ssion. | |
163 | ||
164 | CP&E Team 3 - Demo S chedule 2 Stories | |
165 | Shavkat Sh amukhamedo v 1 Story | |
166 | Table 3: S print 1 CP &E Team 3 - 1 Story | |
167 | Status | |
168 | Story # | |
169 | Rational | |
170 | Descriptio n | |
171 | Acceptance Criteria | |
172 | ||
173 | 005-043 | |
174 | RM# 937656 | |
175 | As the VE I want the system to pause the current P DI with a TOB FC 8 w hen All Cl aims / Lin es are Not Complete | |
176 | The system will paus e the Curr ent PDI an d trigger an alert t o send a C STAT messa ge. |
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