RSS #12013031549

CCMSCoverage & Duplicate

member folder
Client Server
Software Design Document
Version #
Released on
Author

: 0.2
: 08/28/2014
: Sreedhar Reddy

Dell Services
Blue Cross Blue Shield of Rhode Island Account
1 Cookson Place
Providence, RI02903
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Table of Contents
1. Introduction........................................................................................................................ 4
1.1 Purpose.................................................................................................................... 4
1.2 Scope....................................................................................................................... 4
1.3 Out-of-Scope............................................................................................................ 4
1.4 Contact Details......................................................................................................... 5
1.5 Intended Audience.................................................................................................... 5
1.6 Acronyms and Definitions......................................................................................... 5
1.7 References............................................................................................................... 5
1.8 Requirement Summary............................................................................................. 6
2. Design Approach................................................................................................................ 8
2.1 Current Processing................................................................................................... 8
2.2 Proposed Processing............................................................................................... 9
2.2.1 Approach........................................................................................................ 9
2.2.2 Technical details...........................................................................................10
3. Architectural Design......................................................................................................... 16
3.1 Architectural Representation..................................................................................16
3.2 Architectural Goals and Constraints.......................................................................20
3.3 Use-Case View and Realizations...........................................................................20
3.4 Process View (Optional).........................................................................................20
3.5 Deployment / Implementation View (Optional)........................................................20
3.5.1 Overview....................................................................................................... 20
3.5.2 Layers........................................................................................................... 20
3.6 Data View (Optional)..............................................................................................20
3.7 Performance Considerations (Optional).................................................................20
4. General Design and Implementation................................................................................21
4.1 Interfaces with Other Systems................................................................................21
4.2 List of Impacted Inventory......................................................................................21
4.3 Exception Handling.................................................................................................22
4.4 Software Distribution..............................................................................................22
4.5 Reusable Components........................................................................................... 22
4.6 Scheduling Impact.................................................................................................. 22
5. Database Design.............................................................................................................. 22
6. Inputs and Outputs........................................................................................................... 23
6.1 Screen Layouts....................................................................................................... 23
6.2 Report Layouts....................................................................................................... 23
6.2.1 Input Structure..............................................................................................23
6.2.2 Output Structure...........................................................................................23
7. Non-Development Services Considerations.....................................................................23
8. Constraints....................................................................................................................... 23
9. Assumptions and Issues.................................................................................................. 23
10. Appendices...................................................................................................................... 24
10.1 Appendix 1 Data Flow Diagram of Existing process............................................24
10.2 Appendix 2 Queries to create IMEMBER.CMS file..............................................24
10.3 Appendix 3 Queries to create IMEMCVR.CMS file..............................................24
10.4 Appendix 4 Queries to create IMEMCVRO.CMS file...........................................24
10.5 Appendix 5 Queries to create IMEMPCPH.CMS file...........................................25
10.6 Appendix 6 Query to extract next DFG sequence number from CCMS...............25

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10.7 Appendix 7-Mapping Sheet....................................................................................25

11. Amendment History.......................................................................................................... 26
12. Approval of Final Document.............................................................................................26

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1. Introduction
1.1 Purpose
The purpose of this document is to present the Client Server Functional Specification & Software
Design for the RSS #12013031549 CCMS Coverage & Duplicate member folder.
This request is to 1) correctly display the members current coverage, 2) correct the members
historical coverage start and end dates and 3) merge deactivated records with the members active
record so that each member record is whole within the CCMS system.

The purpose of this document is to identify the Member Eligilibility for CCMS.

1.2 Scope
The scope of this RSS includesmodifying thecurrent Member/Coverage extract process which loads
data from the EDR/ODS/Facets into CCMS such that the records are written to the .CMS file based on
the comparison process between the EDR and the CCMS data unlike the existing process where the
member Data that was added after the last CCMS update timestamp is extracted from the EDR and
sent over to the CCMS load process
Along with this, the whole CMMEMB process will be redesigned on Datastage 8.1 and the member
merge process (CMEVENT) will be merged in that one single flow.
The Following changes is done to meet the requirement for Prospect

Indicate on the CCMS Eligibility file that the Medicare Advantage

Members have a Prospect PCP.

1.3 Out-of-Scope
The following items are out of scope for this RSS:

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1.

Data mapping between the EDR and CCMS with respect to any key or non-key data elements
of member eligibility data. The CCMS eligibility data load process must work using the
existing data mapping structure.

2.

Issues related to Consistent Member Id where the Legacy member Id is different for the same
member. This issue will need to continue to be addressed by users through other systems, such
as LRSP and Facets, with corrections through the appropriate business departments.

3.

Data stage job dependency issues creating increases in processing time these issues are
being handled separately as production incidents and the resolutions should be implemented
in Production before the RSS is implemented.

4.

Any issues with FEP membership. FEP membership does not reside in the EDR.

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5.

Benefits extract and upload process.

6.

Providers extract and upload process.

1.4 Contact Details

Name

Location

Contact
Number

Requested by

Natalie Figueiredo

RI

Project Manager

Abhijit Adak

RI

2916

Business Analyst

VikasSaini

RI

1717

Primary Business Customer

Natalie Figueiredo

RI

POC

ManojYaduvanshi

Noida

3860

Developer

Swati Madan

Noida

2117

Quality Control

AmarjeetGulati

Noida

3860

DBA

1.5 Intended Audience

Name Primary Stakeholders

Role

Natalie Figueiredo

Primary Business Customer

Shared Services

Department

Maureen Beaudoin

IMU Lead

EIM

Al Zannini

IMU Lead

Application Design
& Support

Abhijit Adak

Delivery Manager

ADM

Development Team

Development

ADM

Testing Team

Testing

ADM

1.6 Acronyms and Definitions

Please refer to the RAID document attached in Section 9.

1.7 References
Name
BRS_12013031549_CCMS_Coverage & Duplicate member folder_V1.0_20121115

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1.8 Requirement Summary

Essential (E) Implies the system will not be acceptable unless the requirements are provided
in an agreed-upon manner

Conditional (C) Implies these are requirements that would enhance the software product;
would not make the system unacceptable if they were absent

Optional (O) Implies a requirement that may or may not be worthwhile

Priority
E/C/O

Source

BR01

EDR

Extract all active

eligibility records

BR02

CCMS

Extract all active

eligibility records

BR03

DataStage

Join both data sets

to keep all records
from EDR and
CCMS

BR04

DataStage

Filter out
unchanged records

DataStage

Format remaining
records based on
most current data
elements available

BR06

DataStage

Load remaining
records into text file
of the CCMS
required format

BR07

CCMS

Load records using

CCMS interface

Run merge process

on all
members,including
those with events,
open reminders
and active cases

BR05

BR08

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Requirement
Description

Additional
Supporting
Information

Requirement
ID

DataStage

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Requirement
ID

Source

BR09

DataStage

BR10

BR11

BR12

DataStage

DataStage

DataStage

Requirement
Description

Additional
Supporting
Information

Priority
E/C/O

Establish priority
for merge process

Propagate all
members with
event, open
reminders and
active cases to
merge process the
same day a change
has occurred

Reevaluate if there
is a limit to the
number of merge
records that can be
processed in a
single night and
reset that limit
accordingly
Combine all
DataStage daily
processes into one
master series and
run the jobs
sequentially in one
stream

Suggested by Mike
Goldrick

SR_PM_CCMS01:( BFR71179)
BCBSRI CM and UM staff
must be able to uniquely identify Medicare
Advantage members with a Prospect PCP so that they may transfer any CM or DM
activities to Prospect.
SR_PM_CCMS01.1:
Add/Identify a field on the CCMS eligibility file that will indicate the Medicare
Advantage Member with prospect PCP.
Changes would be required in IMEMCVR.CMS
Medicare Advantage Members in CCMS can be identified by
member_coverage.benefit_plan = "3" (PLAN_DESC =
CHiPMedicare)
Prospect PCPs can be identified as: PCPs in Table CMC_NWPX_RELATION
Field - NWPX_ID
ID CHRC

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Get the Provider Ids from above criteria, create a custom table/file
and feed this list to the PCP_ATTRIBUTION_FACT and get the list
of all the Members associated with the PCPs.
The Med Adv Members who have the attributed PCPs can be
identfied
by
joining
Consistent
Member
Id
with
PCP_ATTRIBUTION_FACT table and get the Id who have
attributed PCPs and use these PCPs to perform above look up.
Changes would be required in Eligibility Files sent to CCMS to
uniquely identify Medicare Advantage Members with prospect PCP.
There is a field called member_risk_group on the member interface
file. Business is looking to use that field to indicate the member's
PCP is with Prospect. The field is part of an existing interface so that
would just be a change to that DS module.

2. Design Approach
2.1 Current Processing
There are three processes in Datastage to load and update the members data in CCMS. Please refer to
the attached diagram file in Appendix 1 for the logical diagrams of existing systems.
1.

CMMEMB (Datastage 7.5) This is a load to add new members and member coverage data from
the EDR to CCMS. This process extracts the member and coverage details from the EDR that
have the highest end date subsequent to the last CCMS update timestamp. These records are then
selected for delivery to CCMS. This process generates the following export files for CCMS on a
daily basis:
a.
b.
c.
d.

2.

CMRETRO (Datastage 7.5) This process compares the CCMS members against the EDR
members and activates/deactivates members or member coverage records in CCMS This process
excludes any members with events, open reminders or active cases at this time. This process
generates the following export files for CCMS on a weekly basis:
a.
b.

3.

member file - IMEMBER.CMS

member coverage file - IMEMCVR.CMS
member coverage other file - IMEMCVRO.CMS
member pcp history file - IMEMPCPH.CMS

member file - IMEMBER.CMS

member coverage file - IMEMCVR.CMS

CMEVENT (Datastage version 7.5.2) - In this process the CCMS Member Data for Inactive
Members is compared with Active members based on the Legacy_Member_id or Policy Number.
This process is also called the Member Merge Process. and generates the following export file
for CCMS on a weekly basis:
a. member merge file - ITRANS.CMS

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2.2 Proposed Processing

As per the proposed processing, all the above member processes (CMMEMB, CMRETRO and
CMEVENT) will be merged together into one daily process to address both the retroactivity and
member merging. And this daily process will be newly created in Datastage 8.1. Also the approach to
capture the new/changed records for load from EDR to CCMS will be changed.

2.2.1 Approach
The complete architectural design is attached in section 3 of the document.
ForBR01 thru BR12 and BR17,
The below approach will be used for generating the .CMS files that will be loaded at CCMS through
the REFRESH process:
1.

2.
3.
4.

5.

Extract the membership or coverage or pcp history data from EDR (depending upon the type
of extract to be generated) for only those members that are having the
LEGACY_SOURCE_CODE as 370LRSP or 370FACS and
MEMBER_MEDICAL_COB_CODE not equal to N.
Convert all the data elements from EDR according to the existing CCMS data mapping.
Extract the membership or coverage or pcp history data from CCMS (depending upon the
type of extract to be generated) for only those members that are active and whose
MEMBER_ID are not prefixed with a $ or FEP.
Compare each and every data element of the EDR and CCMS extracts obtained from step 1
and step 3 respectively using the Change Capture stage of Datastage. Based on the
comparison, incoming data will be segregated in to 4 extracts:
New records: Those records that are in EDR but not in CCMS
Changed records: Those records that are in both EDR and CCMS but with a change in
values of one or more columns.
Unchanged records: Those records that are in both EDR and CCMS with all columns
values exactly same.
Void records: Those records that are in CCMS but not in EDR
In case of membership extract, process the void records as per the merge process (explained
later in this section). In case of coverage and pcp history extract, combine the new, changed
and void records (with ACTIVE_CODE as N) to create the .CMS files to be updated in
CCMS through REFRESH process.

MERGE PROCESS
The void members will be processed further using the below steps:
1. Check if any of the members has any case/event/reminder/note in CCMS or not. If not, the
member can be deactivated in CCMS.
2. The LEGACY_MEMBER_IDs of the members having any case/event/reminder/note in CCMS
will be looked up in EDR to check if the member exists in EDR with same
LEGACY_MEMBER_ID but different CONSISTENT_MEMBER_ID. If the member exists,
write the members old CONSISTENT_MEMBER_ID and new CONSISTENT_MEMBER_ID in
ITRANS.CMS file.

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There will be no change in the approach for creating member coverage other extract. The job will
be just re-designed on datastage server 8.1 without any change.
Refer the Technical details section for more details.

2.2.2 Technical details

New jobs will be created on version 8.1 of Datastage.
Datastage Project:
Folder/Category:
Sequence:
Jobs:

DMDDEV
Jobs\CCMS\CMMEMB
CMMEM_UPD_SEQ
CMMEM_UPD_SOJ
CMMEM_MBR_SEQ
CMMEM_MBR_CMPR
CMMEM_MBR_MERGE
CMMEM_MBR_EXT
CMMEM_CVR_EXT
CMMEM_CVRO_EXT
CMMEM_PCP_EXT
CMMEM_GEN_FILE_LST
CMMEM_GET_NXT_SEQ_NUM
CMMEM_UPD_EOJ

All the intermediate files, final extracts and the EOJ will be created at the unix location
/data/dev/dmd/ccms/cmmemb/ on BRIDDU0027 server.
Below are the job details:

1.

CMMEM_UPD_SEQ
Job Sequence will be controlling the execution of jobs. In case an error comes, the whole
Datastage process will be terminated.
Following job activities would be part of the sequenceCMMEM_UPD_SOJ
CMMEM_MBR_SEQ (sub-sequence)
CMMEM_CVR_EXT
CMMEM_CVRO_EXT
CMMEM_PCP_EXT
CMMEM_GEN_FILE_LST
CMMEM_GET_NXT_SEQ_NUM
CMMEM_UPD_EOJ

2.

CMMEM_UPD_SOJ
This job will delete the previously generated EOJ file.

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3.

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CMMEM_MBR_SEQ
This job sequence will be called by the master sequence CMMEM_UPD_SEQ.
Following job activities would be part of this sequenceCMMEM_MBR_CMPR
CMMEM_MBR_MERGE
CMMEM_MBR_EXT

4.

CMMEM_MBR_CMPR
This job will perform the steps mentioned below:
1. Extract the member demographic data from the view VW_MEMBER of EDR for all
members having the LEGACY_SOURCE_CODE as 370LRSP or 370FACS and
MEMBER_MEDICAL_COB_CODE<> N. Refer the query EDRExtract.sql used to
extract the EDR data attached with Appendix 2. Retain the EDR extract query results
in to a sequential file EDR_Mbr_Ext.txt to be used further in merge process.
Also store the subscriber id, dependent number and consistent member id of all
members coming out of the query in an intermediate file NZ_member.txt to be used
in member other coverage process.

2.

3.

The impute PCP Id for the member comes from a file that is created from the job
CMImputePCP90A ofanother process CMImputPCPUpdate. As per the existing
design, the process is creating a hash file. The process will be modified a little to create
a sequential file PCPImpute.txt as well along with the hash file so that it can be ftped
to datastage server 8.1 and can be used in this CCMS membership process.
Extract the member demographic data from tables MEMBER and MEMBER_PHONE
of CCMS database for all the active members (ACTIVE_CODE = Y) that are not
having MEMBER_ID prefixed with a $ or FEP (as FEP or temporary members do
not exist in EDR). Refer the query CCMSExtract.sql used to extract the CCMS data
attached with Appendix 2.
Compare the EDR and CCMS extract created in above two steps using a Change
Capture stage. Key to be used to join both extracts is
EDR.CONSISTENT_MEMBER_ID= CCMS.MEMBER_ID
Four extracts will be created based on the above compare process:
a) NewMbrRecExt.txt: All the records that are present in EDR but not in
CCMS will be captured in NewMbrRecExt.txt file.
b) ChangedMbrRecExt.txt: All the records that are present in both EDR
and CCMS but with a change in values of one or more columns will be
captured in ChangedMbrRecExt.txt file.
c) UnchangedMbrRecExt.txt: All the records that are present in both EDR
and CCMS and having all columns values exactly same will be
captured in UnchangedMbrRecExt.txt file. (The file will not be used
further but it has been created for the analysis purpose.)
d) VoidMbrRecExt.txt: All the records that are present in CCMS but not in
EDR will be captured in VoidMbrRecExt.txt file.

5.

CMMEM_MBR_MERGE
This job will process the void records captured in VoidMbrRecExt.txt using the below steps:

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1.

The job will first check if any of the members is having any case/event/notes/reminder
(open/closed) in CCMS or not. If the member is not having any
case/event/notes/reminder in CCMS, the job will write the record in an intermediate
file InactiveMbr.txt with the ACTIVE_CODE of that member as N. Refer the query
CaseStatus.sql used to check the case/event/reminder/notes status attached with
Appendix 2.
If (AUTH_STATUS = 'X' AND REF_STATUS = 'X' AND SERV_STATUS = 'X'
AND CAS_STATUS = 'X' AND REMD_STATUS = 'X' AND NOTE_STATUS =
X)
Then deactivate the record
Else move to step 2
2.
3.

6.

The members for whom any case/event/notes/reminder exists in CCMS will be

processed in further steps.
The job will then check the existence of members coming from step 1 in the
EDR_Mbr_Ext.txt file created in step 1 of CMMEM_MBR_CMPR job using the key
POLICY_NUMBER (i.e. the LEGACY_MEMBER_ID in EDR). This check will
capture all records having same LEGACY_MEMBER_ID but different
CONSISTENT_MEMBER_ID. All these records will be merged and written to the
ITRANS.CMS file.
The members having any of the case/event/notes/reminder status (from step 1) as O
(open) will be written to the ITRANS.CMS file first followed by the members with
closed/deactivated case/event/notes/reminder (having status C) with a limit of 1000.
No limit will be applied to the open case/event/notes/reminder.

CMMEM_MBR_EXT

This job will merge the below files and create a single file IMEMBER.CMS to be sent to CCMS.
1.
2.
3.

7.

NewMbrRecExt.txt (created out of step 3(a) of CMMEM_MBR_CMPR job)

ChangedMbrRecExt.txt (created out of step 3(b) of CMMEM_MBR_CMPR job)
InactiveMbr.txt (created out of step 2 of CMMEM_MBR_MERGE job)

CMMEM_CVR_EXT
This job will create the file IMEMCVR.CMS using the steps mentioned below:
1. Extract the member coverage data from the view
VW_MEMEBER_ELIGIBILITY_FACT join to VW_MEMBER using key
MEMBER_ID of EDR for all members having the LEGACY_SOURCE_CODE as
370LRSP or 370FACS and MEMBER_MEDICAL_COB_CODE<> N. Refer the
query EDRExtract.sql used to extract the EDR data attached with Appendix 3.
The Plan Id for the member comes from a file that is created from the job
CMBenProd12F ofanother process CMBenUpdate. As per the existing design, the
process is creating a hash file. The process will be modified a little to create a
sequential file NZProduct.txt as well along with the hash file so that it can be ftped
to datastage server 8.1 and can be used in this CCMS coverage membership process.
2.

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Extract the member coverage data from tables MEMBER_COVERAGE and

MEMBER_COVERAGE_HISTORY ofCCMS database for all the active member
coverages (ACTIVE_CODE = Y) that are not having MEMBER_ID prefixed with a

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$ or FEP (as FEP or temporary members do not exist in EDR). Refer the query
CCMSExtract.sql used to extract the CCMS data attached with Appendix 3.
3. Compare the EDR and CCMS extract created in above two steps using a Change
Capture stage. Keys to be used to join both extracts are
MEMBER_ID
BENEFIT_GROUP
BENEFIT_PLAN
BENEFIT_PRODUCT
ENROLLMENT_DATE
The change capture stage segregates the incoming data and passes it to four
different links based on the change code values (i.e. 0, 1, 2, 3)
a) Change code 0: These will be the eligibility records that are present in
both EDR and CCMS and having all columns values exactly same. All
these records will be captured in a file UnchangedCovRecRxt.txt.
(The file will not be used further but it has been created for the analysis
purpose.)
b) Change code 1: These will be the eligibility records (void) that are
present in CCMS but not in EDR. All these records will be passed
further but with the ACTIVE_CODE as N.
c) Change code 2: These will be the eligibility records that are present in
EDR but not in CCMS.
d) Change code 3: These will be the eligibility records that are present in
both EDR and CCMS but with a change in values of one or more
columns.
4. The records coming from steps 3(b), 3(c) and 3(d) will be combined using a funnel
stage and then sorted based on keys
MEMBER_ID
BENEFIT_GROUP
BENEFIT_PLAN
BENEFIT_PRODUCT
ENROLLMENT_DATE
5. The job will then check for multiple occurrences of
MEMBER_ID || BENEFIT_GROUP || BENEFIT_PLAN || BENEFIT_PRODUCT ||
ENROLLMENT_DATE
If multiple occurrences found, the job will pass only that record that has the value in
column primary_secondary as P (Primary coverage).
6. All the records coming from step 5 will be written to a file IMEMCVR.CMS that will
be sent to CCMS.

8.

CMMEM_CVRO_EXT
This job will create the file IMEMCVRO.CMS using the steps mentioned below:
1. Extract the member other coverage data from the table TB_MHN_NON_OCCURS of
ODS based on the criteria specified in the query attached with Appendix 4.
2. Get the members consistent member id from the file NZ_member.txt created in step 1
of CMMEM_MBR_CMPR job by joining the querys result with the file data based on
the keys SUBR_ID_KEY and DEP_NO and fetching the CONSISTENT_MEMBER_ID
from the file. Drop the records that are not matched.
3. Get the Facets other coverage data coming from the input file IMEMCVRO.TXT and
merge it with data coming from step 2 using a funnel stage. Retain the merged data in a
sequential file IMEMCVRO.CMS that will be sent to CCMS.

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CMMEM_PCP_EXT
This job will create the file IMEMPCPH.CMS using the steps mentioned below:
1. Extract the member PCP data from the views VW_MEMBER_PCP_FACT_ALL joined
with VW_PROVIDER on PROV_ID of EDR based on the criteria specified in the query
attached with Appendix 5.
2. Extract the member PCP data from the table MEMBER_PCP_HISTORY ofCCMS
database for all the active PCPs (ACTIVE_CODE = Y) that are not having
MEMBER_ID prefixed with a $ or FEP (as FEP or temporary members do not exist in
EDR). Refer the query CCMSExtract.sql used to extract the CCMS data attached with
Appendix 5.
3. Compare the EDR and CCMS extract created in above two steps using a Change Capture
stage. Keys to be used to join both extracts are MEMBER_ID, MEMBER_PCP (i.e.
LEGACY_PROV_ID in EDR) and PCP_START_DATE.
The change capture stage segregates the incoming dataand passes it to four
different links based on the change code values (i.e. 0, 1, 2, 3)
a) Change code 0: These will be the records that are present in both EDR
and CCMS and having all columns values exactly same. All these
records will be captured in a file UnchangedPCPRecExt.txt. (The file
will not be used further but it has been created for the analysis
purpose.)
b) Change code 1: These will be the records that are present in CCMS but
not in EDR. All these records will be passed further but with the
ACTIVE_CODE as N.
c) Change code 2: These will be the records that are present in EDR but
not in CCMS.
d) Change code 3: These will be the records that are present in both EDR
and CCMS but with a change in values of one or more columns.
4. The records coming from steps 3(b), 3(c) and 3(d) will be combined using a funnel stage
and written to a file IMEMPCPH.CMS that will be sent to CCMS.

10.

CMMEM_GEN_FILE_LST
The job creates the file IFILELST.CMS from the input file IFILELST.SAV placed at the
location /data/dev/dmd/ccms/cmmemb/ on BRIDDU0027 server. This file is further used in
REFRESH process.

11.

CMMEM_GET_NXT_SEQ_NUM
The job extracts the next sequence number for the DFG folder from the CCMS_CONFIG
table of CCMS database using the query attached with Appendix 6and writes it to a file
DFGSEQ.TXT. In case the next sequence number in database is less than 10, the job prefixes
the sequence number with 00, else if it is less than 100, job prefixes the sequence number
with 0 else pass it as is.

12.

CMMEM_UPD_EOJ
This job will create a End of Job file having the input, load and the reject counts.

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13.CMMS_PCP
SR_PM_CCMS01: BCBSRI CM and UM staff must be able to uniquely
identify Medicare Advantage members with a Prospect PCP so that they may transfer
any CM or DM activities to Prospect
New dataStage job will Created to identify the Medicare Advantage Member
WithProspectPCP.

Medicare Advantage Members can be identify as below

member_coverage.benefit_plan = "3" (PLAN_DESC = CHiPMedicare)

Changes would be required in

IMEMCVR.CMS
Prospect PCPs can be identified as
CMC_NWPX_RELATION
Field - NWPX_ID
ID CHRC
Members associated with the PCPs.
PCP_ATTRIBUTION_FACT
Changes would be required in Eligibility Files sent to CCMS to uniquely
identify Medicare Advantage Members with prospect PCP.

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3. Architectural Design
3.1 Architectural Representation
The architectural representation of the Delta process is shown in the below diagram:

DATASTAGE PROCESS
Active EDR, ODS
and Facets Records

Conversion
to CCMS
data elements

New or Changed
Active CCMS
records

File Created for

CCMS
interface data
load

CCMS
Interface for
customer data
load

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Void/Y

Any Cases/
Confidential
Events/Reminders/Not
es?

Consistent Member Id
Change?

Drop record, no
change to CCMS,
keep member active

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The architectural representation of the Merge process is shown in the below diagram:

Proceed with creating

merge records file to
send to CCMS.

Use CCMS data to

create record with
Active Status=N

YES
NO

Void/Y

Consistent Member Id
Change?

Any Cases/
Events/Reminders/Not
es?

YES
NO
Drop record, no
change to CCMS,
keep member active

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The below screenshot depicts the Data stage job design of the master-sequence
CMMEM_UPD_SEQ:

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The below screenshot depicts the Data stage job design of the sub-sequence
CMMEM_MBR_SEQ:

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3.2 Architectural Goals and Constraints

Not Applicable.

3.3 Use-Case View and Realizations

Not Applicable.

3.4 Process View (Optional)

Not Applicable.

3.5 Deployment / Implementation View

(Optional)
Not Applicable.

3.5.1 Overview
Not Applicable.

3.5.2 Layers
Not Applicable.

3.6 Data View (Optional)

Not Applicable.

3.7 Performance Considerations

(Optional)
Not Applicable

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4. General Design and

Implementation
4.1 Interfaces with Other Systems
EDR, ODS and CCMS databases

4.2 List of Impacted Inventory

A) Program
Sr. No.

Name

New/Old

CMMEM_UPD_SEQ

New

CMMEM_UPD_SOJ

New

CMMEM_MBR_SEQ

New

CMMEM_MBR_CMPR

New

CMMEM_MBR_MERGE

New

CMMEM_MBR_EXT

New

CMMEM_CVR_EXT

New

CMMEM_CVRO_EXT

New

CMMEM_PCP_EXT

New

10

CMMEM_GEN_FILE_LST

New

11

CMMEM_GET_NXT_SEQ_NUM

New

12

CMMEM_UPD_EOJ

New

13

CCMS_PCP

New

Change Summary

Requirement
Number
BR01 thru BR12
and BR17
BR01 thru BR12
and BR17
BR01 thru BR12
and BR17
BR01 thru BR12
and BR17
BR01 thru BR12
and BR17
BR01 thru BR12
and BR17
BR01 thru BR12
and BR17
BR01 thru BR12
and BR17
BR01 thru BR12
and BR17
BR01 thru BR12
and BR17
BR01 thru BR12
and BR17
BR01 thru BR12
and BR17
SR_PM_CCMS01

B) Copy Books, Schema Definitions, File Layout

Sr. No.

Name

New/Old

Change Summary

Requirement
Number

New/Old

Change Summary

Requirement
Number

N/A

H) Database
Sr. No.

Name
N/A

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4.3 Exception Handling

Each Data Stage job contains an Exception Handling Stage. It is configurable in the job to create a
warning or ABEND in any step of the job. Below is an excerpt from the DataStage Exception
documentation.
An exception activity handles the situation where a job in the sequence fails to run (other exceptions in
the job sequence are handled by triggers).
An exception activity can only have a single unconditional output trigger, so does not require a
Triggers page. It has no input triggers. It serves as a starting point for a sequence of activities to run if
an exception has occurred somewhere in the main sequence.

4.4 Software Distribution

The Data Stage jobs reside in Categories in each DataStage project. The jobs in respective category
will be exported from Development and imported into UAT by the IS Data Center staff. After UAT
testing, the Category will be exported from UAT and imported into Production by the IS Data Center
staff.

4.5 Reusable Components

Not Applicable.

4.6 Scheduling Impact

Not Applicable.

5. Database Design
Not Applicable.

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6. Inputs and Outputs

6.1 Screen Layouts
Not Applicable.

6.2 Report Layouts

6.2.1 Input Structure
Not Applicable.

6.2.2 Output Structure

Not Applicable.

7. Non-Development Services
Considerations
Not Applicable.

8. Constraints
Not Applicable.

9. Assumptions and Issues

Please refer to the RAID document as attached below:

RAID 12013031549_CCMS_ Coverage & Duplicate member folder.xlsx

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10. Appendices
10.1 Appendix 1 Data Flow Diagram of
Existing process
Member process for
CCMS.vsd

10.2 Appendix 2 Queries to create

IMEMBER.CMS file

EDRExtract.sql

CCMSExtract.sql

CaseStatus.sql

10.3 Appendix 3 Queries to create

IMEMCVR.CMS file
EDRExtract.sql

CCMSExtract.sql

10.4 Appendix 4 Queries to create

IMEMCVRO.CMS file

ODSExtract.sql

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10.5 Appendix 5 Queries to create

IMEMPCPH.CMS file
EDRExtract.sql

CCMSExtract.sql

10.6 Appendix 6 Query to extract next

DFG sequence number from CCMS
GetNxtSeqNum.sql

10.7 Appendix 7-Mapping Sheet

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CareEnhanceCDSInt
erfaceGuide.pdf

11. Amendment History

Version

Date

Additions / Modifications

Prepared / Revised By

0.1
0.2

12/21/2012

Initial Version

Swati Madan

08/31/2015

Updated for CCMS_PCP

Sreedhar Reddy

12. Approval of Final Document

Name

Role / Position

Michael Gold rick

Tech Lead

ADM Peer Review Committee

Peer Review

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Signature / Date

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