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Process Benefit Applications by Using a Guided Flow
Check whether an application in review is complete and accurate. Correct details based on evidence and, if necessary, return the application for additional information. When the application is complete, if the applicants are eligible, assign them a benefit amount.
Required Editions
| View supported product editions. |
| User Permissions Needed | |
|---|---|
| To use the benefit application review guided flow: | OmniStudio User AND Rules Engine Runtime AND Program and Benefit Management Access AND Discovery Framework Platform User AND Document Checklist AND Decision Explainer Service Access AND Group Membership AND Case Referral |
| To access benefit disbursements: | Benefit Disbursement Access |
| To create interaction summaries: | Interaction Summary |
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From the App Launcher, find and select Individual Applications, and
then select an application whose Application Status is In Review.
The benefit application guided flow appears in the Review Application section of the page.
- Under Application Summary, see the number of participants in the application, their total monthly income, their total expenditure, and estimated eligible benefit amount.
- (Optional) For more information about the participants, click the number of participants.
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To check the completeness and accuracy of the application, click Review
Application.
- Review the head of household and household member details. Check whether the members have applied to any benefit programs, and whether anyone is disabled or elderly.
- Review the income details and proof of income. Confirm that the income details in the application match the details in the proof of income.
- Review the expense details and proof of expenses. Confirm that the expense details in the application match the details in the proof of expenses.
- If you find any discrepancies in the application details, contact the application participants. If possible, change the details based on evidence. Capture the details of consultations in an interaction summary.
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If you make changes, review the application again to ensure that your changes are saved.
Then, to update the application, resubmit it.
Resubmitting the application creates an assessment version that includes your changed responses. If the application participants aren’t eligible for the benefit based on the changed responses, the guided flow changes the application status to Denied.
- If you don’t make changes, close the tab and return to the individual application record page.
- If you find missing or incorrect details in the application or require the additional supporting documentation, to return the application to the participants, click Return Application.
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To see whether application participants are eligible to receive a benefit amount, click
Check Eligibility.
In the left pane, under Variables, you see the data points that the flow uses to determine benefit eligibility. If you changed a response to an application question, the updated data appears.
- To check how benefit eligibility changes if you change a particular detail, edit the value of a variable.
- To calculate the benefit amount that the application participants are eligible for, click Simulate.
- To check whether the application participants already receive other benefits, click Other Applied Benefits.
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To finish processing the application:
- Under Benefit Assignment, click Assign Benefit.
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Confirm that the application is complete and that you want to assign the eligible benefit
amount.
The guided flow stores the application data in these objects.
Application Data Object Household member’s role in the application, relationship to the primary applicant, and benefit eligibility Public Application Participant Household member’s name, date of birth, and mobile phone number Person Account Household member’s income Party Income Household expenses Party Expense Household member’s disability status and effective start and end dates of any disability Person Disability Household address Contact Point Address Household member’s citizenship, race, and ethnicity Contact Profile Household details Account, Party Relationship Group, and Account Contact Relationship If the application participants are eligible for the benefit, the guided flow populates the entitlement amount under Benefit Assignment. Specify values for the other fields.
- Select the benefit.
- Select the start and end dates for the benefit amount payout.
- Enter the total amount approved and select the payout frequency.
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To assign the benefit, click Save.
The guided flow creates the benefit assignment and changes the application status to Approved.
- To see the application participants who are eligible for the benefit, under Member Eligibility, click View.
- To view the benefit assignment record page, click the benefit assignment name. The name has the format BA-xxxxxxxxx.
- To view the benefit disbursement schedule, click Disbursement.
