State of Connecticut
Core-CT Project
Application:HRMS
Module:Human Resources
Business Process:Monitor Health & Safety/Workers Compensation
Requirement Number:HR451
Requirement Title:Ability to system generate a claim number
Module Leads: Lina Simonu, Lisa Lagus
- Requirement Description
Describe the requirement (gap). Include a description of the delivered PeopleSoft functionality.
The State of Connecticut needs the ability to system generate a claim number in the current legacy format. The current system has twelve digits to store the claim number. The first four digits identify the agency at which the claim occurred, the next two are the year of the incident, the next three are the Julian date and the last three are the sequence number. PeopleSoft, as delivered also system generates a claim number, however, the number is generated sequentially, statewide and it is only eight digits.
- Business Need
Provide a justification for the requirement. Include information about frequency, volume, number of users impacted, etc.
There are currently two-hundred and twenty five thousand workers’ compensation claims open. Agencies are able to identify their claims based on the claim number. The date of the accident must be included in the claim number in order to track claims of employees that have had multiple incidents. This claim number is used by the Agency HR Specialist, the Agency Payroll Specialist, the TPA Staff person, the Physician’s Office Staff and the employee. This specification has also been given to the new TPA to include in processing.
- Required By: (Y/N)
Federal ____Agency ____Bargaining Unit __
State Statutory ____State Regulatory ____State Procedural __Y__
- Requirement Priority
Medium (High, Medium, Low – please see “Requirements Prioritization Criteria”)
- Recommended Solution
Enter an “X” next to the appropriate category
___X____Process Solution
_1__Option Number
______Application Modification
__Option Number
- Explanation for Recommendation
Provide reasons for recommendation. Please do not re-state the description of the solution itself.
The requirement to automatically generate a Claim Number is met by PeopleSoft. The State however, requires the Claim Number be assigned by Agency, Date, and Sequence based on past practice for ease in identification of claims. By allowing the agencies to record the Original Claim Number associated with a re-occurrence through the addition of a field, PeopleSoft could track original claims and re-occurrences. See requirement #HR454.
- Organizational Impact of Recommendation
Describe the changes to the organization that result from the recommended solution. Include a description of any role, process, statute, or bargaining unit agreement affected.
Agency HR Specialists will need to be trained to identify the claim number based on Employee ID, Non-Employee ID, Claim Status, Incident Number, or Provider Claim Number, if applicable.
- Process Solutions
Describe the possible Process Solutions. Include a description of impacts and benefits of each solution.
Option 1. Allow the system to generate the claim number sequentially statewide. The Agency HR Specialists would need access to historical claim information to determine the original claim number in a re-occurrence situation. By having the Claim Number system generated statewide, there is less chance for duplicate claims. Also if an employee transfers from one agency to another, there isn’t an issue determining which agency code is used in subsequent claims that may need historical claim information.
Option 2. Allow the Agency to manually assign each claim number based on the Agency Code (first 6 digits in PS) and the sequence number (last 2 digits in PS) for a total of 8 digits. The date of the claim will be indicated in the delivered Date Opened field when the claim is filed. This field is required. Agencies would continue to be able to identify claims logged to their agency, however, they would be responsible for maintaining the numbering system manually.
- Application Modifications
Describe the possible Application Modifications. Include a description of impacts and benefits of each solution.
Option 1.
Modification Type (On-line, Batch, Interface, Report, Workflow: On-line
Complexity (Easy, Medium, Difficult): Difficult
Description: Add peoplecode to assign the claim number based on the employee’s current Agency Code (PeopleSoft Department ID) and sequence number based on existing claims for the employee. The Claim Number length of 8 digits, would remain as delivered, 6 for the Agency Code and 2 for the sequence number. Add a field to the Department Table to store Last Claim Number assigned by Agency. The peoplecode would reference this number upon saving a new claim and look to determine if the employee had existing claims and increment the sequence number accordingly.
1 of 112/09/18