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P11 Stage Flow

Table of Contents

• Overview
• A
• B
• C
• D
• E
• F
• G
• H
• I
• J
• K
• L
• M
• N
• O
• P
• Q
• R
• S
• T
• U
• V
• W
• X
• Y
• Z
• Notes

Overview

Definition of sql table column names and how its used in the p11 flow process.

A

• AIP - Audit In Progress
  • Stage when QR initially reviews an intake form audit

B

• BM - Business Manager
  • Businses Owner Manager who oversees their team's BOs'
• BO - Business Owner
  • Creates intake forms, reviews errors charged from QR.
• Business Type No - Is stored in codelist table, lookupcategory = 'Business Type'. Business Type is selected and assigned to an audit in the intake form setup page.
  • Business Type No 1 = New
  • Business Type No 2 = Renewal
  • Business Type No 3 = Maintenance
  • Business Type No 4 = Cancellation

C

• CountID - randomly generated value

  • See smart.p11_IntakeForm table, Create New IntakeForm
  • Specific cases CountID will be the same when two or more Intake Forms are created simultaneously
    • Example: InspectionType - Proclaim (9), selecting "Both" radiobutton creates Proclaim Structure & Proclaim Benefits intake forms, under the same CountID

• All 3 counts below are being used in Daily Production calculations

  • Plan Count
    • Plan Count is counting comma separated plans added for secondary checklists in QR Review Checklist Setup
  • Count
    • Counts are coming from Intake Form creation
  • Class Count
    • Counts are coming from Intake Form creation

D

• DATEADD() - function adds a specified number value (as a signed integer) to a specified datepart of an input date value, and then returns that modified value.

  • [Syntax] DATEADD(datepart , number , date )
    • See Arguments list to see what type of datetype goes in first parameter.
  • [Resource] DATEADD()

• DateEntered - The date a new intake form was created.

• DateClosed - when an audit has been finalized by QR.
• DATEPART() - function returns an integer that represents the specified datepart of the specified date. For example, you can pass in 2021-01-07 and have SQL Server return only the year portion (2021)
  • [Syntax] DATEPART (datepart , date)
    • See Arguments list to see what type of datetype goes in first parameter.
  • [Resource] DATEPART()

Example of seeing Today's day of week

--Example 1
SELECT DATEPART(WEEKDAY, GETDATE())

--Example 2
SELECT  CASE DATEPART(WEEKDAY,GETDATE())
    WHEN 1 THEN 'SUNDAY'
    WHEN 2 THEN 'MONDAY'
    WHEN 3 THEN 'TUESDAY'
    WHEN 4 THEN 'WEDNESDAY'
    WHEN 5 THEN 'THURSDAY'
    WHEN 6 THEN 'FRIDAY'
    WHEN 7 THEN 'SATURDAY'
END

• DatePend - when QR pends an audit either in Checklist Setup or 1st QR Review page.
• DateReleased - date when the intake form was released from the Intake Form page.
• DateReceived - Updates when an Intake Form is released and updates again when an QR click get next.
• DateReadyToAudit - when QR moves an audit from Checklist Setup to 1st QR Review (or when "Move to 1st QR Review" button is clicked)
• DateSubmitted - date when the intake form was submitted, in any stage.
• DateRebuttalOpened - date when BO submits a request for rebuttal to BM.
• DateRebuttalApproved - date when BM submits BO's approved request to SME.
• DateRebuttalClosed - date when SME finalizes rebuttal.

E

• EffectiveDate - Date the data becomes visible.
  • Teams, Intake Forms

F

• FieldTypeNo - is Count LookUpCategory's LookUpNo
  • See Additional Information section in Aging Inventory Report
• FIFO - First In First Out
• Final Error - When an error is added to a field in QR 1st Review it will be added to table (smart.p11_AuditChecklist_Fieldlist) and the column Final Error will be given a value of 1. If the error is removed, it won't be considered a final error and the final error will be reverted (FinalError = 0).

G

• Group Management - Team Setup
• GSP - Global Service Partner
  • Teams that are located outside of the US.
  • Example GSP groups are Chennai & Manila.

H

I

• InventoryNo - each stage is given a unique value.
  • See Rebuttal Flow Table to compare other values side by side.
  • | | New | AIP | 1st QR Review | Pend | 1st BO Review | 2nd BO Review | 3rd+ BO Review | QR Recheck | Closed | Rebuttal New | Rebuttal Review | Rebuttal Final | |---|:---:|:---:|:---:|:---:|:---:|:---:|:---:|:---:|:---:|:---:|:---:|:---:| | InventoryNo | 0 | 1 | 3 | 2 | 4 | 5 | 6 | 7 | 10 | 11 | 12 | 20 |

J

K

L

M

N

O

• Offshore - Location indicator for international teams for Cigna
  • See GSP under (G)
• Onshore - Location indicator for domestic teams for Cigna.
• An audit is considered On or Off Shore / GSP Restricted depending on the Account.
• An Account is only considered On Shore / GSP Restricted if it has an Indicator of 2.

P

• PriorityNo - When a new intake form is created it will be defaulted to PriorityNo = 20 (FIFO), Deferred = 0 (No), IsEscalated = 2 (No)
• Chart below shows the correct combination of PriorityNo, Deferred, IsEscalated values depending on which priority is assigned to an Intake Form.
• PriorityNo, Deferred, IsEscalated columns are found in the table smart.p11_IntakeForm and can be updated in the QM Review page.

• Select PriorityNo, DeferredAccount, IsEscalated from smart.p11_IntakeForm

  • | | PriorityNo | Deferred | IsEscalated | |---|:---:|:---:|:---:| | FIFO | 20 | 0 | 2 | | Escalated | 2 | 0 | 1 | | Deferred | 3 | 1 | 2 |

Q

• QA - Quality Auditor (sometimes name is called QR or Auditor)
  • One who audits or charges an error to a BO's intake form
• QM - Quality Manager
  • Oversees QR in their team.
  • Has ability to create Facets / non-facets intake forms
  • Can Delete intake forms in any stage, reset comments, reopen BO's rebuttal past 3 days
• QR - Quality Reviewer (sometimes name is called QA or Auditor)
  • One who audits or charges an error to a BO's intake form

R

• RebuttalStageNo - value that determines which rebuttal stage the rebuttal is in.

  • See Rebuttal Flow Table to compare other values side by side.
  • RebuttalStageNo is being used in both p11_IntakeForm and p11_Audit_Checklist_FieldList levels.
  • | | New | AIP | 1st QR Review | Pend | 1st BO Review | 2nd BO Review | 3rd+ BO Review | QR Recheck | Closed | Rebuttal New | Rebuttal Review | Rebuttal Final | |---|:---:|:---:|:---:|:---:|:---:|:---:|:---:|:---:|:---:|:---:|:---:|:---:| | RebuttalStageNo | - | - | - | - | - | - | - | - | - | 1 | 2 | 3 |

• ReportPlanCountNo is being used to dynamically calculate daily production.

  • ReportPlanCountNo 1 - Plan Count
  • ReportPlanCountNo 2 - Class Count
  • ReportPlanCountNo 3 - Count

S

• SourceDocumentNo - (smart.p11_SourceDocument) SorceDocumentNo is used in the Check list setup page, when the 'Tip' button is clicked.
• SequenceNo - value increments each time an audit goes back and forth between BO and QR
• Site - also known as Location
  • Refers to Onshore or Offshore teams
• SME - Subject Matter Expert
  • If a QR has a question about a field error during an audit, they will usually send question(s) to a SME for confirmation.
• StageNo - value given to determine where the audit stage is in within the flow process.
  • See Rebuttal Flow Table to compare other values side by side.
  • | | New | AIP | 1st QR Review | Pend | 1st BO Review | 2nd BO Review | 3rd+ BO Review | QR Recheck | Closed | Rebuttal New | Rebuttal Review | Rebuttal Final | |---|:---:|:---:|:---:|:---:|:---:|:---:|:---:|:---:|:---:|:---:|:---:|:---:| | StageNo | 0 | 1 | 2 | 2 | 4 | 4 | 4 | 3 | 10 | - | - | - |
  • Note: StageNo is not used for: Rebuttal New, Rebuttal Review, Rebuttal Final
• rbt Show Buddy / QR Inventory tab Gridview - when rbt show buddy is selected user may view all intake forms that are associated with their team.

T

• TransactionEffectiveDate - is coming from the feed in Core_CEM dbo.CEM_IntakeForm, column CASE_EF_DT
• TeamClassificationNo - are RoleTypeNo's, For example, TeamClassificationNo = 1 is 'Quality'

U

• UniqueID - tied to UniqueInstanceNo. See smart.p11_IntakeForm table in [CORE_CEM] database.

V

W

X

Y

Z

Notes

Rebuttal Flow Table