{"action":"created","issue":{"url":"https://api.github.com/repos/g4gaurang/bcbsmaissuestracker/issues/265","labels_url":"https://api.github.com/repos/g4gaurang/bcbsmaissuestracker/issues/265/labels{/name}","comments_url":"https://api.github.com/repos/g4gaurang/bcbsmaissuestracker/issues/265/comments","events_url":"https://api.github.com/repos/g4gaurang/bcbsmaissuestracker/issues/265/events","html_url":"https://github.com/g4gaurang/bcbsmaissuestracker/issues/265","id":110304664,"number":265,"title":"Other Practitioner Office Visit cost share  per occurence verbiage cascading incorrectly","user":{"login":"g4gaurang","id":10272072,"avatar_url":"https://avatars.githubusercontent.com/u/10272072?v=3","gravatar_id":"","url":"https://api.github.com/users/g4gaurang","html_url":"https://github.com/g4gaurang","followers_url":"https://api.github.com/users/g4gaurang/followers","following_url":"https://api.github.com/users/g4gaurang/following{/other_user}","gists_url":"https://api.github.com/users/g4gaurang/gists{/gist_id}","starred_url":"https://api.github.com/users/g4gaurang/starred{/owner}{/repo}","subscriptions_url":"https://api.github.com/users/g4gaurang/subscriptions","organizations_url":"https://api.github.com/users/g4gaurang/orgs","repos_url":"https://api.github.com/users/g4gaurang/repos","events_url":"https://api.github.com/users/g4gaurang/events{/privacy}","received_events_url":"https://api.github.com/users/g4gaurang/received_events","type":"User","site_admin":false},"labels":[{"url":"https://api.github.com/repos/g4gaurang/bcbsmaissuestracker/labels/Build-P19.5.11.16","name":"Build-P19.5.11.16","color":"eb6420"},{"url":"https://api.github.com/repos/g4gaurang/bcbsmaissuestracker/labels/Environment-Production","name":"Environment-Production","color":"eb6420"},{"url":"https://api.github.com/repos/g4gaurang/bcbsmaissuestracker/labels/Priority-ShowStopper","name":"Priority-ShowStopper","color":"e11d28"},{"url":"https://api.github.com/repos/g4gaurang/bcbsmaissuestracker/labels/Status-%20In-Process","name":"Status- In-Process","color":"bfdadc"},{"url":"https://api.github.com/repos/g4gaurang/bcbsmaissuestracker/labels/Type-Defect","name":"Type-Defect","color":"e11d21"}],"state":"open","locked":false,"assignee":{"login":"michparrish","id":13471811,"avatar_url":"https://avatars.githubusercontent.com/u/13471811?v=3","gravatar_id":"","url":"https://api.github.com/users/michparrish","html_url":"https://github.com/michparrish","followers_url":"https://api.github.com/users/michparrish/followers","following_url":"https://api.github.com/users/michparrish/following{/other_user}","gists_url":"https://api.github.com/users/michparrish/gists{/gist_id}","starred_url":"https://api.github.com/users/michparrish/starred{/owner}{/repo}","subscriptions_url":"https://api.github.com/users/michparrish/subscriptions","organizations_url":"https://api.github.com/users/michparrish/orgs","repos_url":"https://api.github.com/users/michparrish/repos","events_url":"https://api.github.com/users/michparrish/events{/privacy}","received_events_url":"https://api.github.com/users/michparrish/received_events","type":"User","site_admin":false},"milestone":{"url":"https://api.github.com/repos/g4gaurang/bcbsmaissuestracker/milestones/1","html_url":"https://github.com/g4gaurang/bcbsmaissuestracker/milestones/Milestone-Post_1.1","labels_url":"https://api.github.com/repos/g4gaurang/bcbsmaissuestracker/milestones/1/labels","id":1218933,"number":1,"title":"Milestone-Post_1.1","description":null,"creator":{"login":"g4gaurang","id":10272072,"avatar_url":"https://avatars.githubusercontent.com/u/10272072?v=3","gravatar_id":"","url":"https://api.github.com/users/g4gaurang","html_url":"https://github.com/g4gaurang","followers_url":"https://api.github.com/users/g4gaurang/followers","following_url":"https://api.github.com/users/g4gaurang/following{/other_user}","gists_url":"https://api.github.com/users/g4gaurang/gists{/gist_id}","starred_url":"https://api.github.com/users/g4gaurang/starred{/owner}{/repo}","subscriptions_url":"https://api.github.com/users/g4gaurang/subscriptions","organizations_url":"https://api.github.com/users/g4gaurang/orgs","repos_url":"https://api.github.com/users/g4gaurang/repos","events_url":"https://api.github.com/users/g4gaurang/events{/privacy}","received_events_url":"https://api.github.com/users/g4gaurang/received_events","type":"User","site_admin":false},"open_issues":11,"closed_issues":33,"state":"open","created_at":"2015-07-21T19:45:25Z","updated_at":"2015-10-14T20:36:57Z","due_on":null,"closed_at":null},"comments":2,"created_at":"2015-10-07T20:00:39Z","updated_at":"2015-10-15T16:07:26Z","closed_at":null,"body":"A Benefit Expert has reported the following issue - \r\nWhen attempt to generating a SBC for a Master Medical Indemity plan, the Other Practitioner Office Visit field should read:  20% coinsurance / chiropractor visit.    This is the standard so initially I didn’t make any changes to the field before generating the plan.   See below screenshot of what was in the configurator.\r\n \r\n![image](https://cloud.githubusercontent.com/assets/10272072/10349308/dbeb2284-6d0b-11e5-86c2-1dc1e7cd1567.png)\r\n\r\n\r\n\r\nOnce I generated the plan, that field (along with the other cascade fields) only said 20% coinsurance.   See below: \r\n![image](https://cloud.githubusercontent.com/assets/10272072/10349316/e83ea146-6d0b-11e5-8a19-a49787fed166.png)\r\n \r\n\r\nI think part of the issue is that in the Primary Care Visit field (the one that we use to cascade, it appears that what is coded is “20% coinsurance” instead of “20% coinsurance per visit.”   Thus when we generate the plan we only get \"20% coinsurance” instead of “20% coinsurance / visit.”   \r\n\r\n \r\n![image](https://cloud.githubusercontent.com/assets/10272072/10349329/f863fcc4-6d0b-11e5-8703-c5dde2957967.png)\r\n\r\n\r\nThis is an issue with all indemnity plans..\r\n\r\n\r\nIn addition, when I tested a PPO plan to check the casacading for the 20% coinsurance this is what I notice - the per occurence verbiage is missing on in-network but present on the out-of-network.\r\n3453473_Lisa Test 18_Preferred_Blue_80_Copay_444TESTS\r\n![image](https://cloud.githubusercontent.com/assets/10272072/10349267/9a68a638-6d0b-11e5-9767-a4a94b645056.png)\r\n\r\n\r\nPlease fix globally and test all plan types for this issue."},"comment":{"url":"https://api.github.com/repos/g4gaurang/bcbsmaissuestracker/issues/comments/148438115","html_url":"https://github.com/g4gaurang/bcbsmaissuestracker/issues/265#issuecomment-148438115","issue_url":"https://api.github.com/repos/g4gaurang/bcbsmaissuestracker/issues/265","id":148438115,"user":{"login":"michparrish","id":13471811,"avatar_url":"https://avatars.githubusercontent.com/u/13471811?v=3","gravatar_id":"","url":"https://api.github.com/users/michparrish","html_url":"https://github.com/michparrish","followers_url":"https://api.github.com/users/michparrish/followers","following_url":"https://api.github.com/users/michparrish/following{/other_user}","gists_url":"https://api.github.com/users/michparrish/gists{/gist_id}","starred_url":"https://api.github.com/users/michparrish/starred{/owner}{/repo}","subscriptions_url":"https://api.github.com/users/michparrish/subscriptions","organizations_url":"https://api.github.com/users/michparrish/orgs","repos_url":"https://api.github.com/users/michparrish/repos","events_url":"https://api.github.com/users/michparrish/events{/privacy}","received_events_url":"https://api.github.com/users/michparrish/received_events","type":"User","site_admin":false},"created_at":"2015-10-15T16:07:26Z","updated_at":"2015-10-15T16:07:26Z","body":"Hi all,\r\n\r\nHR has determined that the request is not a defect, but is an enhancement request.\r\nPlease see the attached LOV value requirement document below. We did not receive instruction to add 'per visit' to the end of coinsurance LOV values, only the copay values. To update all workbooks and test in both CPE2 and then pclient5 will be an LOE of 5 hrs.\r\nJust a note that if this change is made, the new value will cascade to all of the following fields:\r\nSpecialist Visit\r\nchiropractor (other practitioner office visit)\r\nMental/Behavioral Outpatient\r\nSubstance Use Disorder Outpatient\r\nRehabilitation Services\r\nHabilitation Services\r\nUrgent Care\r\n\r\nAdditionally, we also do not have the requirement to change any cascaded values from Primary Care to Other Practitioner's Office Visit from '/ visit' to '/ chiropractor visit'. This is not expected behavior in the OON field right now, and therefore is technically a defect. However, since is functioning as we would want it to work, it would be an enhancement request to make this update to all workbooks for all INN and OON fields and test to ensure it's working properly. To make this update to the workbooks and test in both environments will be an additional LOE of 5 hrs. \r\n\r\nPlease let us know if you would like us to make these changes.\r\n\r\n[Final Sprint 2 CascadingRules_Plan Management _3 18 15 with 4 28 demo 1 1 items  5 11 QA.xlsx](https://github.com/g4gaurang/bcbsmaissuestracker/files/14191/Final.Sprint.2.CascadingRules_Plan.Management._3.18.15.with.4.28.demo.1.1.items.5.11.QA.xlsx)\r\n"}}