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Health Insurance Project Requirement
Health Insurance Project Requirement
Project
Organisation Name-Alere
Developer
Admin
CSR
Pharmacist
MD
Provider search
Member search
Drug search
Questionnaire
Pharmacist Approval
Medical director Approval
Resolve
Provider ID
Provider name
Provider address
Provider email
Provider Phno
Member ID
Member name
Member email
Member address
Member Phno
Drug name
Dosage
Taken through
NO of days to be taken
Formulary alternatives
Go to data explorer
Add new data type and create a new data class as Members
Memberid
Member Name
Member email
Member phone number
Member address
Add new data type and create a new data class as Drugs
Fields as BElow
Gpc
Ndc
Drug name
Dosage
Formulary alternative
Follow the above instructions and create another data class for providers
Providerid
ProviderName
Provideremail
Providerphonenumber
Provider address
User should enter provider id and hit on search button, then provider details like provider
name , address, email , phone number should display in repeating grid or table layout
Code Configuration:
In provider search section add a text box for entering provider id and a search button.
Create a datapage of type list and source as activity which can hit the database and get the
provider details based on provider id.
Add “on click” Refresh action on Search button. On click of search the table layout should
refresh and display provider details.
In the repeating grid add a select button and name it as “Select Provider”.
pyWorkPage.ProviderID = Primary.ProviderID
Trigger the data transform from the “select Provider” button using onclick event.
2. Member search:
3. Drug search:
Create paragraph rules for each question (Right click on class Create User Interface
Paragraph (write your question here and save it))
Once the paragraph rules are created, open questionnaire question and drag paragraph control
and map paragraph rule in it , then the question will display.
A1. Create a property and give local list values, Yes NO (Refer network property in banking
project)
A2. Create a property with local list values with Mouth or Intraveinal
Map the above created answer properties to the questionnaire section below the corresponding
Question
If the drug Mg is less than or equal to 50 Mg and if taken by Mouth Approve the case
If the drug Mg is greater than 50 Mg and taken either by mouth or Intraveinal Pend the case
7. Add a decision shape in the questionnaire flow and trigger the above created decision table
8. The outgoing connector from the decision table with the result as approve should be connected
to end shape and the other connector with result pend should be connected to “ChangetoStage
“ Smart shape to route to Pharmacist approval stage
9. Create a section and flow action named Approve with read only fields to display selected
provider, member, drug details.
10. Create a section and flow action named Reject to capture Reject reason.
11. In pharmacist approval stage add approve and reject screens from same assignment on its 2
outgoing connectors.
12. Upon case approval end the flow by connecting it to end shape.
13. If case is rejected add change to a stage smart shape and route to Medical director approval
stage.
14. Add above created approve reject screens on same assignment in medical director approval
flow like we configured above.
16. Add status as Resolved approved on approve connector and status as resolved rejected on
reject connector.
Configuring Routing:
Create a report definition rule in work class to display Resolved –Rejected cases and plug it in
manager portal under Reports category using category and shortcut rules.
SLA
Create a SLA rule named as “PharmacistApprovalSLA” , when deadline time expires resume flow on
approve flow action, which means it should auto approve.
Create a SLA rule named as MDApprovalSLA when goal expires send reminder email, when deadline
expires auto approve case.
Agents
Create a advanced agent which triggers an activity which identified the cases whose pystatuswork is
“Resolved Approved” sends email to all the approved cases with subject holding case id approved and
body of mail holding all details.