How It Works

This section describes how fixed processing by the Engine and custom processing combine to calculate and display key decision factors.

The calculation and display of a determination involves a mixture of:

• fixed processing contributed by the Engine; and
• custom product-specific processing contributed by the implementation of the product.

Note that it is not mandatory to configure custom key decision factors for your product periods; any or all of the product periods can opt not to use key decision factors, and if so no custom key decision factors will be displayed for those periods.

The Engine follows the following high-level steps to arrive at key decision factors that can be displayed to a case worker:

• At Determination Calculation time:
  • An action occurs which triggers the determination of a case (either an active or reactive determination);
  • The Engine identifies the product periods (configured for the product) that cover the case's lifetime;
  • The Engine uses CER rules (specific to the product) to calculate the custom key decision factors for each contributing product period;
  • The Engine calculates the key decision factors across the lifetime of the case by "splicing together" the key decision factors from each contributing product period;
  • The Engine stores (on the database) a determination result containing the key decision factors data (as well as eligibility/entitlement results and decision details, covered elsewhere in this document).
• At Determination View time:
  • A case worker requests to view a determination on a case;
  • The Engine retrieves the determination result from the database and interrogates the determination result to obtain its key decision factors;
    • the fixed case and decision factors for the determination, using the summarizer strategy configured for the product to produce a summary of the case's entitlement for each decision; and
    • the custom key decision factors for the determination (if any).

The data interfaces and implementation for calculation of key decision factors, and subsequent display of key decision factors are described in more detail below.