Test if the software meets the user/business requirements. “Business process validation is the act of verifying end-to-end business process. It is performed step-by-step to confirm that all business rules are working correctly and when any deviation is found the defects are logged.“[1] The business process test is defined in the QTP/UFT framework as a scenario that includes a series of business components flow, designed to test a specific business process for an application.

An example of a business process testing scenario in openIMIS will be:

1. Business process flow (using the JLN flow)

2. Business process test flow

3. Business process test components

Business component 1: Login to openIMIS as an enroller

Business component 2: Save the QR code of a new beneficiary

Business component 3: Save the picture and personal information of a new beneficiary in the website

Business component 4: Assign a insurance number to a beneficiary

Business component n:

List of standard business scenarios from the JLN process (Joint Learning Network Report 2012)


Major Process Groups

Business Processes

Core

Processes

Beneficiary Management  

Enroll beneficiary

Assign beneficiary to a Primary Care Provider (PCP) or primary care unit 

Eligibility inquiry by provider 

Eligibility inquiry by beneficiary 

Pre-authorization  

Provider Management

Register/ empanel provider 

Provider agreement 

Premium Management

Premium collection

Claims Management

Claims processing

Claims status inquiry

Claims dispute and appeals

Claims adjustment and voids

Accounting

Payment to providers

Accounts receivable 

Accounts payable 

Supportive

Processes

Care Management

Manage costs of catastrophic cases 

Identify chronic disease management cases  

Enroll into chronic disease management programs 

Monitor chronic disease management cases 

Utilization Management 

Utilization management

Pharmacy benefits management PBM

Provider Quality Management 

Provider Quality Management

Financial / Audit Management

Actuarial management 

Provider rate  

Set premium

Reserve Fund Management

Medical Loss

Manage medical loss ratio (MLR)

Audit and Fraud

Identify fraudulent cases

Manage fraudulent cases

Source:  Joint Learning Network Report 2012


[1] https://www.softwaretestinghelp.com/what-is-business-process-testing-bpt/