3. User acceptance test/Business process test

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:

Enroll beneficiary

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

	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 Management	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
	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
	Audit and Fraud	Manage fraudulent cases

Source: Joint Learning Network Report 2012

[1] Business Process Testing (BPT) How to Simplify Testing Process

openIMIS

3. User acceptance test/Business process test

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