S-BEN-02 · W19 Benefits and Eligibility · fit: unknown
Record Medicare, Railroad and Part D coverage
As a benefits coordinator, I want to record a patient's Medicare or Railroad Retirement entitlement, with each part's dates, and their Part D plan, so that Medicare is billed for the parts the patient has on the visit date.
| Persona | benefits_coordinator |
|---|---|
| Journey | A patient's coverage is recorded |
| Step | Records the coverage Task_04_RecordsTheCoverage |
Scenarios
| S-BEN-02.1 | Given a patient with no Medicare on file, When I record their Medicare beneficiary identifier, the name on the card, and Part A and Part B with effective dates, Then MEDICARE ELIGIBLE (#9000003) holds the patient with that identifier and one eligibility entry per part with its dates. |
|---|---|
| S-BEN-02.2 | Given a Medicare beneficiary identifier that is not in the identifier's format, When I save, Then it is refused and nothing is filed. |
| S-BEN-02.3 | Given a name on the card that is not `LAST,FIRST MIDDLE`, When I save, Then it is refused and names the format. |
| S-BEN-02.4 | Given a Railroad Retirement beneficiary, When I record their number and parts with effective dates, Then RAILROAD ELIGIBLE (#9000005) holds the patient with those parts and dates. |
| S-BEN-02.5 | Given a patient with Medicare on file, When I record a Part D plan with its insurer, member number and effective date, Then the Part D eligibility is filed with that insurer and listed with the patient's coverage. |
| S-BEN-02.6 | Given a Medicare part recorded in error, When I remove that eligibility entry, Then MEDICARE ELIGIBLE (#9000003) no longer holds it and the other parts are unchanged. |