Prescription Carve-out requirements - BPMS-I-16 AB-172 EA-249 AB-194

[g4gaurang]

We would like to get a level of effort and timeline assessment on the Prescription Carve-out requirements for SBCs. We have shared these requirements with you in the past. You can also find them below: (click link)

https://drive.google.com/file/d/0B_7OzEEzvKXzUEFTb3IxdnZxcGM/view?usp=sharing https://drive.google.com/file/d/0B_7OzEEzvKXzZ244WDZ2bXNNZXc/view?usp=sharing

Requirement for Prescription CarveOuts.docx |

RxCarveOutExampleTiebackToRequirements.doc |

Let us know if you have questions.

@markderg @jddecoste

[michparrish]

Will, Those are additional requirements and will be submitted to Dev as such. They will respond with LOE and assessment. As is, have you confirmed that the button is working as expected, where regardless of if Carve Out is selected or not, all files are routing to the correct folder?

[willdwyer]

So far, it seems the Carve Out functionality is working in PCLIENT5, but we still have a lot more testing to do.

And, we consulted again internally, and we would like to add these requirements to it. The Rx Carve Out Plan radio button on the generator should be placed below the Output button, and should be grayed out unless the Word option is selected for Output.

Please let us know the additional LOE and assessment.

[michparrish]

Received notice today from the Development team that the next enhancement review cycle will be the first week of May. They will assess the priority of this item among all client enhancements.

My recommendation would be to move the code and configuration as is, if you've been able to test out the routing is correct, and we can enhance the location of the button and the 'graying out' at a later time, so you have this functionality in place sooner than later. Please let us know. Thank you.

[willdwyer]

Michelle,

So, you are saying that they wouldn't be able to change the coding for the Rx Carve Out Plan mapping button until first week of May? Please provide a finite date when this would be completed by.

[michparrish]

Will - I'm saying the Dev team will not be reviewing this item (their prioritization meeting) until the first week of May. Only then can I provide more of an idea on when this item will be prioritized with all of the other items on Dev's plate and a date for you.

[willdwyer]

Michelle, we will discuss this on Friday, as I just discussed internally with Kevin.

Why aren't we seeing wire frames/UI infomation before enhancements go out? Kevin brought this up at the last conference call we had.

[michparrish]

Hi Will, I'm not sure what you mean. We discussed this last week and all agreed we would present samples prior to moving code, when a UI change is requested/needed. Since then, there has not yet been a need for a wireframe. Were you expecting a wireframe of something this week?

[willdwyer]

Hi Michelle,

Has HR started to review this yet? (it is the first week of May now)

Also, we discussed wireframes on the last weekly defect call (on Friday). Tim/Mark indicated they would be provided to us in the coming weeks.

[michparrish]

Hi Will,

We reached out to the Dev team this morning to ask when they will be holding their meeting to evaluate all items in the queue. We'll keep you posted. Thank you, Michelle

[TimHeasley]

The dev team is working through a few critical top priorities and have not had the capacity to investigate the LOE to support the new requirement. We hope to have a response possibly end of today, if not EOD early next week.

[TimHeasley]

Will, Attached are the wire frames for the carve out.

Requirements:

1) Placement of the 'Rx Carve Out Yes/No' field to be below the Output options (Word, PDF) 2) Rx Carve Out field to be grayed out unless the user has selected both *Mark Plan Document as: 'Final' and Output : 'Word'. When this combo is selected, the Rx Carve Out field should be enabled. Thanks, Tim

Prescription Carve-out requirements - Wireframe.docx

[willdwyer]

Hi Tim,

We reviewed these wire frames internally, and this works for us. Please proceed with implementing the enhancement.

[TimHeasley]

Thank you for reviewing and approval. We will move forward with the request.

[TimHeasley]

We have advised the development to proceed and let us know when the build takes place. After the build we will test in PClient5 and let you know when it is ready for retest in PClient5.

[TimHeasley]

Will, We have moved the enhancement to PClient5 and it is ready for retest. Let us know if you have any questions. Thanks, TIm

[willdwyer]

Encountered this during testing generation of a final carve out word document.

[TimHeasley]

Hi Will, Can you let me know the steps you took when you received the error? I created a new plan using 3530621 from your example above as the base and I was able to generate a document (3579452). Thanks, Tim

[willdwyer]

1. Go to Content Library
2. Marketing and Sales/Custom/TJX folder
3. Selected checkbox next to plan design, clicked Edit, Go to Manage Plan
4. In configurator, made necessary steps to change to Carve Out (Plan Details, Carve Out - Yes, Misc Fields, Carve Out - Yes),
5. In configurator, changed Minimum Value Standard to Does Not Meet
6. Changed Minimum Creditable Coverage to Does Not Meet
7. Saved/Validated
8. Clicked Plan Documents button
9. Entered Final, Word, Carve Out - Yes radio mapping button
10. Generated

[willdwyer]

I'm also getting this error when trying to create a Custom from a standard in the configurator.

[willdwyer]

Just got it again. See screenshot.

Same steps, except see the plan I used in the screenshot.

[TimHeasley]

Thanks for sending all of the details. We are working to get the permissions fixed. We'll let you know as soon as it is completed.

[TimHeasley]

Will, We are researching the issue, were you using IE10 at the time of the issue? Thanks, Tim

[willdwyer]

Yes, we were using Ie10.

[willdwyer]

Assigning to Michelle, as I know Tim is on vacation.

[michparrish]

Hi Will,

Permissions issues have been fixed in pclient5 and I retested the new code, logged in as You, and it tested successfully. Please continue with your testing and let me know how it goes. Thanks! michelle

[willdwyer]

Not fully implemented.

After testing an HCCS plan (specifically 800034HR_HMO_Blue_NE_Ded_1000_Coins_80-0263HCCSSG1-1-16), the Carve Out logic did not apply correctly. Per screen shot, the Highest Cost Share columns still has cost share information. Please make this fix to all plans.

[michparrish]

Hi Will, I see the plan you used. Did you use the Carve Out Yes/No fields within the configurator on this? Those are what impact the data itself. Please send me the steps you took to update the copy of 800034HR so I can replicate. Thank you!

[willdwyer]

Michelle,

The steps were as follows...

1. Go to Manage Plan
2. Search for: Effective Date - 2016 Product Group Type - HMO Blue NE Plan Type - Standard
3. Hover over plan 800034HR_HMO_Blue_NE_Ded_1000_Coins_80-0263HCCSSG1-1-16
4. Click Create a New Custom
5. Plan Details tab - Carve Out, yes
6. Misc Fields tab - Carve Out, yes
7. Proceed to Save/Validate
8. Carve Out radio mapping button, Yes
9. Final, Word
10. Generate

[michparrish]

Thanks! I was able to recreate. I've passed this along to update the workbook(s).

[michparrish]

Ok, all set. All workbooks have been updated. Please begin retesting again and let me know how it goes. Thanks!

[willdwyer]

Hi Michelle,

I am still encountering errors. When entering Yes for Carve Out in the Misc Fields tab, it does not seem to be saving. See screenshot below for the Advantage Blue plan I tested that still has cost share amounts for Rx drug information.

Please note I tested this three times over to confirm.

[michparrish]

Alright - the EPO workbook has been updated and retested successfully. Please let me know if you run into any other issues. Thanks!

[willdwyer]

Still more issues...

Tried creating a carve out from a PPO Blue Options plan (800168HR_PPO_Blue_Options_v.5_80-0222MMASCBF1-1-16) and the Carve Out button is missing from the Plan Details tab. See screenshot.

[michparrish]

that is odd. I see it when I pull up a different plan, but not this one. I'm going to send to our QA dept. There should be no reason why an attribute is missing from this page. Additionally, I did make sure that the attribute for this plan had a value, in case a missing value was the reason it wouldn't show. It does show that the value for this plan is 'No' for the Carve Out attribute.

[willdwyer]

@mattrimer

[michparrish]

this is all set - workbook has been updated. It was missing the 'Carve Out' attribute row in one of the tabs. I've confirmed this row is accounted for in all of the other workbooks. Please continue retesting. Thanks!

[mattrimer]

After retesting on PClient5 I found that this issue still exists. The Carve Out button is missing from the Plan Details tab.

See screenshot:

[michparrish]

Hi Matt, Thanks for retesting - I did a search on that exact plan and called it into the configurator and I see the Rx Carve Out row. Would you mind trying to either clear your cache or refresh? Please be sure you are also using IE10. Please let me know if this works. Thank you!

[mattrimer]

The previous issue regarding the carveout option not showing up in the plan detail screen has been resolved.

However, I found that an issue from last week still exists. The Misc fields tab carveout option still resets to "no" after the word doc has been generated on certain plans. From what I've sampled, I found that Blue Choice local $10 (800202HR) and Blue Choice local Plan 2 (800305HR) have this problem, but I suspect there are more within the Blue choice group that also have this issue. For that reason, I think it would be wise for your team to make sure all plans in this group have been fixed.

[TimHeasley]

Matt, Thank you for testing. I am also seeing that the Rx Carve Out is reverting back to "no" on the Misc Tab. I will research the issue and let you know when you can retest. Thanks, Tim

[TimHeasley]

Matt, We have updated the workbooks, tested & confirmed that the values do not revert for any plans. Ready for retest in PClient5. Thanks, Tim

[mattrimer]

Thanks Tim,

I've retested these plans and found no errors. This item can be pushed to the next step.

[TimHeasley]

Update is being pushed to Production environment the evening of 6/3 we will verify updates and let BCBSMA team know when they can test on Monday.

[TimHeasley]

The enhancement has been moved to Production and is ready for review by the BCBSMA team. Thanks, Tim

[mattrimer]

Looks good, this request is closed.