Program Authorization
Use this information to understand authorization of each program on an application case.
After the caseworker resolves any outstanding verifications that are associated with the application case, the worker can start the program authorization process. Authorization of each program on an application case is required to process the application case to completion. By default in Cúram Health Care Reform, the authorization strategy is set at the program level. After all the programs are authorized, the application case status is set to Closed.
Ongoing case management requires both an integrated case and a product delivery to complete the delivery of services and benefits to clients. Integrated cases are not necessarily created for every program authorization, however. An existing integrated case can be used to host newly created product delivery cases. For Cúram Health Care Reform, if integrated cases exist of the appropriate type for which any of the application case clients is a member, the case worker is presented with the option to use one of these cases or to create a new integrated case.
What can I configure or customize?
Program authorization can be configured at either the application level or at the program level to meet your project requirements. From the Universal Access section of the Admin application, you can configure the program authorization processing for the application case.
When the application level authorization strategy is selected, you must define the authorization Cúram express rules (CER) ruleset. You also must decide whether a new or existing integrated case is appropriate to be used when the program authorization is successful. The integrated case is used to host any product deliveries that are created as a result of the authorization. If a new integrated case is created, all of the application case clients are added as case participants to the integrated case. If an existing integrated case is used, any additional clients on the application case are added as case participants to the integrated case. Any evidence that is captured on the application case that also is required on the integrated case is copied to the integrated case upon successful authorization.
You can choose to authorize the application at the program level when the application case has one or more program types that are associated to it. Separate integrated cases are used to manage the product deliveries that are created as a result of authorization. If you decide to authorize at the program level, then each program must be authorized separately. You can choose to create a new integrated case for each program that is authorized. Alternatively, you can choose to use an existing integrated case or allow the caseworker to select one or the other. You must also define the type of integrated case that is created as a result of authorizing the program. Program Group Logic functionality is used to create and maintain product deliveries. The program group rules are executed in order to determine which clients are eligible for which products. Then the Program Group Logic creates the corresponding products.