Managing Benefits Cases

This chapter includes information that social service and other municipal entitlement agencies can use to manage cases for benefits and services. It includes the following topics:

Scenarios for Benefits Case Management

This topic describes how benefits case management might be used. You might use benefits case management differently, depending on your business model. This topic includes the following scenarios:

Managing Intake

An intake agent at a social service agency meets with a citizen who needs agency benefits. He works with the citizen to complete an electronic application for benefits on a self-service Web site. On the self-service Web site, the intake agent submits the completed application to the agency. Additionally, citizens can access the same self-service Web site to complete applications for benefits themselves.

An intake agent might also receive a referral for benefits from a social worker. The agent might receive referral documents by mail from the citizen’s doctor and other social service specialists. The referral information includes the citizen’s personal information, such as an address, the reason for the recommended services, and a brief description of the problem.

Updating Data

The agent assigned to the submitted application reviews the application and looks for matching contact records for that application. If she does not find a matching contact record for a contact in the application, then she creates a contact record for the citizen. She associates the submitted application with each contact record in the application. She then uploads the information in the application into Siebel Public Sector to distribute data in the application to appropriate data fields for the case and contacts.

If necessary, the agent interviews the citizen to obtain additional information. She can add additional details to the case record and associate scanned document files with the case record. She can also update the contact records to enter additional details about the citizen’s family.

After the application is complete, the agent checks the information in the application to make sure that none of this information is falsified, inaccurate, or invalid.

Assigning Cases

The agent assigns the case to a manager who assumes primary responsibility for coordinating assessment activities. Agents can manually assign cases by adding another user to the Team field of the case and selecting that user as primary. You can also assign cases by setting up an assignment rule. This assignment rule is based on various criteria in the case record.

Assigning Assessment Activities

A manager provides a predefined assessment template that establishes evaluation criteria for the benefits case. The manager organizes a case team to investigate various aspects of the case, assigns assessment activities to each member of the team, and sets a due date for each assessment activity. She can automatically perform these tasks using assignment and workflow rules. These rules are based on worker skills, worker availability, and agency work processes.

Determining Benefits Eligibility

In the intake process, an agent at a social service agency captures details about the situation for a citizen. The agent then screens the citizen’s case to determine the benefits for which the citizen is eligible. She reviews these benefits with the citizen before actually assigning benefits to the citizen’s case. After creating benefit plans with associated benefits and benefit payments, the agent creates referral orders for those benefits that service providers supply. When benefit payments are due, the agent processes these payments.

Later, the agent changes data relating to the citizen’s case because the household income for the case changes. To determine whether this data change affects the citizen’s benefits, the agent automatically scans the citizen’s case to see whether she must reassign new benefits to the case. Consequently, she reassigns benefits to the case. Information about the existing benefits is archived, and the payments for the citizen are automatically recalculated.

Appealing Cases

A citizen is not satisfied with the benefits that she receives, so she notifies an agent that she wants to appeal her case. Although the original case is still in effect, the agent creates an appeal case for the citizen’s original case. This appeal case contains an attachment with information about the original case. To support the appeal, the citizen provides documentation that the agent includes in the appeal case.

A board reviews the evidence in the appeal case to make a decision about the appeal. After this review, the board rejects the appeal. The agent then closes the appeal case.

Reviewing Cases for Quality Assurance

At any time during case processing or after case completion, an agent reviews the details about the case to determine whether the case is processed according to agency procedures and governmental regulations.

About Implementing Automatic Benefits Assignment

To implement the functionality for screening cases for benefits eligibility and the functionality for automatically assigning benefits to cases, administrators can use Oracle Intelligent Advisor to integrate Siebel Public Sector with an application that determines benefits. Data from Siebel Public Sector is relayed to the application. The application determines benefits, and then relays data for the benefit plans, associated benefits, and, if applicable, benefit payments to Siebel Public Sector.

Although a user cannot delete automatically generated plans, associated benefits, and benefit payments, the user can add other benefits, change benefit products, and add other benefit payments. Later, the user can automatically reassign benefits to the case. For such a reassignment, administrators can configure Oracle Intelligent Advisor to consider or to ignore these added benefits, changed benefit products, and added payments. For more information, see Screening Cases for Benefits Eligibility and Automatically Assigning Benefits to Cases.

About the Sample Policy Model

Oracle provides a sample Intelligent Advisor policy model for eligibility determination in the Siebel Public Sector application and for intake on a self-service Web site for Siebel Public Sector Self Service. You can use this sample policy model for eligibility determination associated with the Determinations Server or for intake associated with the Web Determinations Server.

The sample Intelligent Advisor policy model that is shipped with the product is meant to only illustrate the capabilities of the integration between Oracle Intelligent Advisor and a self-service Web site for Siebel Public Sector Self Service.

Extracting the Policy Model Project

The policy model project is packaged in Siebel Tools, and you can extract the policy model project from the following directory:

Tools_install_location\REPPATCH\

About Integrating Siebel Public Sector with Accounts Payable

After a benefit payment amount is determined, an agent can forward payment data for the benefit to an accounts payable application, such as PeopleSoft Enterprise Payables. For more information, see Processing Benefit Payments.

You must modify the SWISendPaymentInstructions workflow to integrate Siebel Public Sector with an accounts payable application. For more information, see SWISend Payment Instructions Workflow.

To implement the functionality for processing benefit payments, administrators can integrate Siebel Public Sector with Oracle Application Integration Architecture. Oracle Application Integration Architecture is a set of products that enables you to set up and orchestrate cross-application business processes so that multiple applications can work together. After payment data for a benefit is forwarded to Oracle Application Integration Architecture, Oracle Application Integration Architecture forwards the payment data to an accounts payable application, and consequently the citizen is paid. The accounts payable application returns payment data, such as the status and number of the payment, to Siebel Public Sector through Oracle Application Integration Architecture.

To integrate Siebel Public Sector with Oracle Application Integration Architecture, use Oracle Application Integration Architecture Foundation Pack. For more information, see the documentation set for Oracle Application Integration Architecture Foundation Pack on Oracle Technology Network.

About Working with Service Providers

Agents can use Siebel Public Sector to manage service providers, to refer benefits cases to them, and to share information about these cases with them. Specifically, agents can enter information about service providers and their contracted prices, locate service providers for citizens, and create referral orders for service providers. For example, agents can use Siebel Public Sector to assign benefits cases for children in need of foster homes to service providers that provide such homes.

Service providers can access the Siebel Public Sector Provider Portal through the Web to enter profile information describing special accommodations that they provide. On this portal, they can maintain an inventory of available services that they provide. They can also work with referral orders for benefits cases by accepting the orders, putting the orders on a waiting list, or rejecting the orders. For more information about working with service providers, see the content about the Siebel Public Sector Provider Portal in Siebel Partner Relationship Management Administration Guide.

About Effective Dating for Field Values and Records

Periodically, the circumstances that relate to a benefits case can change. For example, the household income for the benefits case might decrease, or additional individuals might join the household for the benefits case.

Agents can change effective dating field values to reflect these changes. For more information, see Changing Data in Effective Dating Fields.

Agents can also add or deactivate effective dating records that are associated with the benefits case to reflect these changes. For more information, see Changing Data in Effective Dating Records.

When agents automatically regenerate the plans for the benefits case, the effective dates, and not the dates agents enter the data, are used to redetermine the plans and associated benefits and to recalculate future benefit payments that apply to those plans.

This topic contains the following information:

Effective Dating for Field Values

You can change the values in effective dating fields in any view that contains the fields for an effective dating business component. The preconfigured Siebel Public Sector application includes effective dating business components for income, expenses, financial assets, contacts, and households. Some views that can contain effective dating fields follow:

The following views of the Contacts screen:
- Contacts List
- Contact Administration
- More Info
- Income
- Expenses
- Financial Assets
Contacts views of various screens
The following views of the Households screen:
- More Info
- Contacts
Households views of various screens

After you create a record that contains effective dating fields, an effective date button appears in an effective dating field when you click the field. You can click this button to see the history of values for the field.

When you click the effective date button, the Effective Date dialog box appears. You can enter changes to a field value in this dialog box. For example, in the Income view of the Contacts screen, you can use this dialog box to indicate that the Amount field for an income record is different for a past date range by creating a new entry in this dialog box with the appropriate value for the Field Value field and the appropriate dates in the Effective Start Date and Effective End Date fields.

Status Fields of Field Values for Effective Dating

If administrators enable the Status field for an effective dating field, then the Status field appears in the Effective Date dialog box for the field. If the Status field is enabled, then the Status field is automatically populated with a value of Pending for a changed value in an effective dating field. Only agents with the proper authority can change the Status field value to Approved. For more information about changing the Status field value, see Verifying Changes to Effective Dating Fields.

Only the active field value in the Effective Date dialog box appears in the effective dating field. If the Status field is enabled for the effective dating field, then the active field value has a Status field value of Approved and an effective date range that includes the current date. If the Status is disabled for an effective dating field, then the active field value has an effective date range that includes the current date.

Effective Dating for Records

In the preconfigured Siebel Public Sector application, administrators can set up effective dating for records in the following views:

The following views of the Contacts screen:
- Addresses List
- Income
- Expenses
- Financial Assets
Contacts view of the Households screen

When effective dating exists for the records that you add to a view or deactivate from a view, functionality is available when you click the Link History button in that view.

When you click the Link History button, the Link History dialog box appears. You can enter changes to a record in this dialog box. For example, in the Income view of the Contacts screen, you can use this dialog box to enter changes to an income record as follows:

To indicate that the income record is not effective on or before a past date, select the past date in the Effective End Date field.
To indicate that the income record is not effective on or before the current date, select the current date in the Effective End Date field.
To indicate that the income record is effective for different date ranges, create new entries in this dialog box, and select the appropriate dates in the Effective Start Date and Effective End Date fields for each new entry.

Status Fields of Records for Effective Dating

If administrators enable the Status field for an effective dating record, then the Status field appears in the Link History dialog box for the record. If the Status field is enabled, then the Status field is automatically populated with a value of Pending for an added effective dating record. Only agents with the proper authority can change the Status field value to Approved. For more information about changing the Status field value, see Verifying Changes to Effective Dating Records.

If the Status field is enabled for an effective dating record, then the record is inactive when it has no entry in the Link History dialog box with a Status field value of Approved and with an effective date range that includes the current date. The record is active when it has an entry in the Link History dialog box with a Status field value of Approved and with an effective date range that includes the current date.

If the Status field is disabled for an effective dating record, then the record is inactive when it has no entry in the Link History dialog box with an effective date range that includes the current date. The record is active when it has an entry in the Link History dialog box with an effective date range that includes the current date.

To view inactive and active records in a view, select Show All Records in the view menu. The Inactive field is selected for inactive records and not selected for active records. To view only active records in a view, select Show Active Records in the view menu.

Future Dating

In the Effective Date dialog box for a field value, you can select a future date in the Effective Start Date field and the Effective End Date field only if administrators enable future dating for that field value when they implement effective date tracking. If you select such a date in the Effective Start Date field, then the field value does not appear in the field because the field value is currently inactive. For more information about setting up future dating in the Effective Date dialog box, see Implementing Effective Date Tracking.

In the Link History dialog box for a record, you can select a future date in the Effective Start Date field and the Effective End Date field only if an administrators enable future dating for that record when they implement effective date tracking. If you select such a date in the Effective Start Date field, then the record does not appear in the view of active records because the record is currently inactive. For more information about setting up future dating in the Link History dialog box, see Implementing Effective Date Tracking.

About Appeal Cases

If citizens are not satisfied with the benefits that they receive, then they can notify an agency that they want to appeal their case. For example, they can submit an appeal request on a self-service Web site. A citizen can appeal a case only within a time period that the agency designates. When the agent who manages the citizen’s case knows about the appeal, the agent can create an appeal case for the citizen’s original case. The original case continues to be in effect, and the citizen continues to receive the existing benefits that were established under the benefit plans for that case. You can create multiple appeal cases for a case. For more information, see Process of Managing Appeal Cases.

When you create an appeal case, Siebel Public Sector performs the following steps:

For the original case, selects the Appealed check box, and changes the Status field to Active.
Creates an appeal case in the Appeal Cases view for the original case, populates the Case Name field of this appeal case with the name of the original case followed by Appeal text and the current date, populates the Parent Case field of this appeal case with the name of the original case, and populates the Category field of this appeal case with a value of Appeals.
Users can also view appeal cases in the Case List view of the Cases screen.
Creates an evidence record in the Evidence view for the appeal case, populates the Evidence Name field of this evidence record with Case number (#) text followed by the number of the original case and the current date, and populates the Parent Case field of this evidence record with the name of the original case.
Users can also view evidence for appeal cases in the Evidence List view of the Evidence screen.
Creates a snapshot file in the Attachments view for the evidence record, populates the Name field of this file record with Case number (#) text followed by the number of the original case and Snapshot text, and selects the check box for the System Generated field of this file record.
This snapshot file contains the field values for the original case, for the active benefit plans that are associated with that case, and for the benefits that are associated with those benefit plans. For information about configuring the format and content of this snapshot file, see Process of Configuring Appeal Cases.

Roadmap for Managing Benefits Cases

This roadmap consists of processes and tasks that users typically perform when managing benefits cases. Your agency might follow a different roadmap according to its business requirements.

To manage benefits cases, users perform the following processes and tasks:

Process of Managing Applications

Using the self-service Web site, citizens can submit applications for benefits themselves. Also, agents at call centers, other agency offices, and field locations can use the self-service Web site to submit applications for citizens. For more information about submitting an application for benefits on a self-service Web site, see Siebel Self Service Administration Guide if you use Siebel Public Sector Self Service.

This process consists of tasks that users typically perform when managing applications. Your agency might follow a different process according to its business requirements.

To manage applications, users perform the following tasks:

This process is a step in Roadmap for Managing Benefits Cases.

Reviewing Submitted Applications

Agents can review the submitted applications that are assigned to them in the Applications screen of Siebel Public Sector. You cannot manually enter application records in the Applications screen. This screen is automatically populated with records that represent applications that citizens and agents submit on a self-service Web site.

Siebel Assignment Manager routes applications to agents. This application routing is based on the criteria (for example, the benefits program type of the application) that administrators set up. For more information about automatically assigning submitted applications to agents, see Siebel Assignment Manager Administration Guide.

Benefit plans and associated benefits are automatically assigned to an application in Siebel Public Sector when a citizen submits the application to an agency on a self-service Web site. To qualify for benefit plans, a household must meet the specific criteria that a social service agency defines.

Submitted applications are read-only files in Siebel Public Sector. You cannot change data in submitted applications. You review the data in submitted applications to verify that the data is complete and valid before you upload this data into Siebel Public Sector. When you review an application, you can accept the application for further processing or you can reject the application because it contains incomplete or incorrect data.

This task is a step in Process of Managing Applications.

To review a submitted application

Navigate to the Applications screen.
To view only the submitted applications assigned to you, select My Applications in the visibility filter.
Additional selections in the visibility filter display applications for your team, applications for an organization, and all applications. Applications newly assigned to you have a star icon in the New field of the Applications list.
Drill down on the Name field of the application.
To review information about the application, complete the following steps:
1. Navigate to the Decision Reports view to see details of benefits determination.
  A decision report that is fully expanded appears.
2. For easier viewing, click the Minus (-) icon next to a report line to hide the lines that contain more detail about that line.
  You can click the Plus (+) icon to show the hidden lines.
3. Navigate to the Benefit Plans view to review the benefit plans, benefits, and payments for the application.
4. Navigate to the Application Attachments view, and drill down on the Attachment Name field of attachments included with the application to open and review these attachments.
5. (Optional) If you want to see whether the application was previously rejected, then navigate to the Audit Trail view to see detail about prior submissions of the application.
  Siebel Audit Trail detail about rejected applications or other application information appears only if the administrator sets up a Siebel Audit Trail for submitted applications. For more information, see Setting Up a Siebel Audit Trail for Submitted Applications.
Accept or reject the application.
- If the provided data is complete and correct, then take no action. The Status field of the application automatically changes from Submitted to Processed when you upload the application. For more information, see Uploading Applications.
- If the provided data is incomplete or incorrect, then change the Status field of the application from Submitted to Rejected, select a value in the Reason Rejected field, and, if necessary, enter text in the Comments field to provide more information about the rejection.
  If you reject an application after you match contacts to it, then the matched contacts are no longer associated with the application.

Finding Matching Contact Records

If an agent reviews a submitted application and accepts that application for further processing, then the agent must next perform contact matching. You perform contact matching in Siebel Public Sector to find existing contact records to associate with a submitted application before you upload the data in that application into Siebel Public Sector. If you cannot find existing contact records, then you can create new contact records for the submitted application.

You find matching contact records to make sure that all data for each application contact is associated with a single contact record. When you initially perform contact matching, you might find multiple contact records for a citizen. To clean up your Siebel database, administrators can merge the information in multiple contact records into a single contact record. For more information about merging duplicate records, see Siebel Fundamentals.

Also, you can navigate to the Contacts List view of the Contacts screen to delete extra contact records. Before deleting a contact record, make sure that no cases are associated with that record. Also, make sure that you no longer need any information that is associated with that record, such as activities and notes.

To find matching contact records for an application, the social security number fields in the submitted application are compared to the social security number fields in contact records in Siebel Public Sector. Because children generally have no social security numbers, no matching contact records are found for them in the preconfigured Siebel Public Sector application. Administrators can configure other criteria for contact matching by specifying other data fields, such as the date of birth and last name for the contact, to include in this comparison processing. For more information, see Configuring Contact Matching.

Also, administrators can disable contact matching. For more information, see Configuring Contact Matching.

Note: You can perform contact matching only for applications that have a status of Submitted.

This task is a step in Process of Managing Applications.

To find matching contact records

Navigate to the Applications screen.
To view only the submitted applications assigned to you, select My Applications in the visibility filter.
Additional selections in the visibility filter display applications for your team, applications for an organization, and all applications. Applications newly assigned to you have a star icon in the New field of the Applications list.
Drill down on the Name field of the application.
Navigate to the Contacts Matching view.
The Contact Summary field shows the contacts in the submitted application. The Primary Contact field is selected for the contact who prepared the application.
Complete the following steps to designate the correct contact record for each contact in the submitted application:
1. Click the select button in the Contact Last Name field.
  The Contact Matching dialog box displays any matching contact records for the contact in the submitted application.
2. In the Contact Matching dialog box, designate the correct contact record as follows:
  - If the contact records that appear include the correct contact record, then select that record, and click Pick. You can search for a contact record in the records that appear in the dialog box, but you cannot search for a contact record that does not appear in the dialog box.
  - If you cannot find the correct contact record, then create a new contact record with fields populated with available data from the submitted application, save that record, and click Pick.
  The Contact First Name and Contact Last Name fields in the Contacts Matching view are populated with the corresponding values in the contact record that you select. After you designate the correct contact record for all of the contacts in the submitted application, you can upload the application. For more information, see Uploading Applications.

Uploading Applications

Before an agent uploads application data, this data exists only in the submitted application, and not in the data fields in Siebel Public Sector. When the agent uploads an application, the agent distributes the data in the application to the appropriate data fields in Siebel Public Sector records for the case and associated benefit plans and for the contacts and associated addresses, expenses, income, financial assets, and relationships.

A single master case record is associated with the primary contact record for an application. When you upload application data, you make sure that all cases for the primary contact are associated with this single master case record. Observe the following restrictions about application upload:

You can upload only one application at a time.
To upload an application, you must first associate contacts with that application if contact matching is enabled. For more information about associating contacts with an application, see Finding Matching Contact Records.
You can upload an application only if the status of the application is Submitted. Because an uploaded application has a status of Processed, you cannot upload an application more than once.

This task is a step in Process of Managing Applications.

To upload an application

Navigate to the Applications screen.
To view only the submitted applications assigned to you, select My Applications in the visibility filter.
Additional selections in the visibility filter display applications for your team, applications for an organization, and all applications.
Drill down on the Name field of the application.
Navigate to the Contacts Matching view.
Click Upload.
- If the upload succeeds, then the following changes occur:
  - The Benefit Plans view in the Plans view in the Case List view of the Cases screen appears, and this view shows the benefit information for the newly created case.
  - The Status field of the application changes to Processed, and the Case Number field of the application is populated with data.
  - The Decision Report view in the Plans view in the Case List view of the Cases screen is populated with details about benefits determination.
- If the upload fails, then an error message appears.

Note: If you assign an application to another user or to an organization that you are not a member of, then an error message appears when you click Upload because you cannot upload an application that is not visible to you.

About Application Upload

For a citizen’s contact record, the upload process replaces the field values in the Siebel Public Sector record with the field values in the application. For example, if a citizen’s last name changes because of marriage, then the upload process replaces the maiden name in the Siebel Public Sector contact record with the married name in the application.

For the records that are associated with the contact record (for example, expenses and income), the upload process determines the fields in the user key of the associated record. If the user who submits the application changes the values in the user key fields, and if these field values do not exist for the record that is associated with the contact record, then the upload process adds a new record in Siebel Public Sector. If the user who submits the application does not change the values in the user key fields but changes other field values for the record, then the upload process updates these other field values in the record instead of adding a new record in Siebel Public Sector.

For example, assume that the user key for the expense record includes only the expense type field. If a user enters a new expense type in an application, then the upload process adds a new expense record in Siebel Public Sector. If the user enters a previously submitted expense type in the application but changes the field values for the frequency and amount of the expense, then the upload process updates the frequency and amount fields in the expense record in the Siebel Public Sector record instead of adding a new expense record. Administrators can access the PUB Sample Upload Contact integration object in Siebel Tools to adjust the user key fields for records, or administrators can create a new integration object in Siebel Tools to set up new user key fields for records.

When you upload a benefits application, Siebel Public Sector performs the following steps:

Finds the master case record for the primary contact that is associated with the application. If no master case record exists for this contact, then creates this record.
Creates a child case record, if necessary, for the master case record.
Sets the Type field of the child case to a value of Other.
Sets the Category field of the child case to Benefit.
Populates the field values in Siebel Public Sector with the field values on the application. If an error occurs, then displays an error message and rescinds any changes made to field values in Siebel Public Sector.
Creates a time-stamped XML file that shows all the updates to the Siebel Public Sector field values.

Note: If a citizen submits multiple applications for the same program, then multiple case records for the program can exist for that citizen in Siebel Public Sector. However, the creation date component of the case name differentiates these case records from one another.

Viewing Cases for Applications

After agents upload an application into Siebel Public Sector, they can view the case for that application.

This task is a step in Process of Managing Applications.

To view the case for an application

Navigate to the Applications screen.
To view only the submitted applications assigned to you, select My Applications in the visibility filter.
Additional selections in the visibility filter display applications for your team, applications for an organization, and all applications. Applications newly assigned to you have a star icon in the New field of the Applications list.

Drill down on the Case Number field of the application.

The Case form appears with views that show more details about the case.

The following table describes some of the fields.

Field	Description
Case Name	Displays the name of the case. This field has the following format: Contact Full Name - Creation Date - Application Number. To view the case, drill down on this field.
Case Type	Displays the type of benefits or immigration program applicable to the case. For cases that are automatically created from applications submitted on a self-service Web site, this field has a value of Other, but agents can change this value. Additional values include Food Stamps, Medical Assistance, Cash-Financial Assistance, Child Care, Unemployment, Visa, Passport, and Citizenship.
Status	Displays the status of the case in the agency’s processing. Values include: Submitted. The case is submitted for manager approval. Rejected. A manager did not approve the case. Active. A manager approved the case, and agents are working on the case. Inactive. A manager approved the case, and agents are no longer working on the case. Closed. The case is closed.

Field

Description

Case Name

Displays the name of the case. This field has the following format: Contact Full Name - Creation Date - Application Number. To view the case, drill down on this field.

Case Type

Displays the type of benefits or immigration program applicable to the case. For cases that are automatically created from applications submitted on a self-service Web site, this field has a value of Other, but agents can change this value. Additional values include Food Stamps, Medical Assistance, Cash-Financial Assistance, Child Care, Unemployment, Visa, Passport, and Citizenship.

Status

Displays the status of the case in the agency’s processing. Values include:

Submitted. The case is submitted for manager approval.
Rejected. A manager did not approve the case.
Active. A manager approved the case, and agents are working on the case.
Inactive. A manager approved the case, and agents are no longer working on the case.
Closed. The case is closed.

Verifying Application Information

Agents must verify the information in an application to make sure that citizens qualify for benefits. For example, to verify an application for worker’s compensation, the agent might check with the employer to verify that the worker was injured while working, the worker was employed at the time of the injury, and the worker was employed for a specified number of months before the injury. The agent might also check with a physician to verify that the worker cannot work because of the injury. Other examples of the information that agents might verify include social security numbers, addresses, the number of household members, and unemployment records. For more information about attaching an electronic version of verification information to the application, see Adding Attachments to Applications.

To verify the information in an application, you select a verification plan template that is associated with the value in the Case Type field for the case that is associated with the application. After you save the verification plan, the list of items that you must verify appears in the Verification Items list. After you verify an item, you update the item in this list.

After you select a template for a verification plan, you can delete that template only if all of the template items do not have a check in the Verified field. You cannot add items to or delete items from a template that you select to create a verification plan.

When you verify application information, you might find incorrect data in the case or contact records. In this scenario, you can complete the following tasks:

Change the incorrect data. For more information, see Updating Contact Records.
Determine whether the changed data revises benefits for the citizen. For more information, see Checking for Necessary Benefits Reassignments.
Regenerate the benefits for the case. For more information, see Reassigning Benefits to Cases.

This task is a step in Process of Managing Applications.

To verify the information in an application

Navigate to the Applications screen.
To view only the submitted applications assigned to you, select My Applications in the visibility filter.
Additional selections in the visibility filter display applications for your team, applications for an organization, and all applications. Applications newly assigned to you have a star icon in the New field of the Applications list.
Drill down on the Case Number field of the application.
The Case form appears with views that show more details about the case.

Navigate to the Verification Plans view, create a new record in the Verification Plans list, and complete the fields as appropriate.

The following table describes some of the fields.

Field	Description
Planned Start	Select the date and time that you plan to begin verifying the application information.
Template Name	Select the appropriate template to use to verify the application information. You must select a template to create a verification plan. If necessary, you can change the value in the Case Type field for the case to select a different template. After you save the verification plan and exit the case record, you cannot change the Case Type field of the case.
Name	Displays the name of the template that you select, but you can change this value to a different name.
Description	Displays the description of the template that you select.

Select Save Record in the menu that appears when you click the cogwheel icon for verification plans.
The items that are associated with the template that you select appear in the Verification Items list after the Verification Plans list.
After you finish the verification work for an item in the Verification Items list, complete the following steps:
- In the Verified field, select the check box for the item.
  When you select another field for the item, the Date Verified field is populated with the current date and time, and the Verified By field is populated with your user name.
- (Optional) In the Information Type field, select a value to indicate the nature of the information that you verified for this item.
- (Optional) In the Verification Type field, select the method of your verification for this item.
- (Optional) Enter any remarks in the Comments field.

Adding Attachments to Applications

Agents can add more detail to an application record by attaching relevant documents and other external media using the Application Attachments view of the Applications screen. The attachment can be in any format, such as a word-processing document.

The attachments that citizens add on a self-service Web site also appear in the Application Attachments view of the Applications screen.

You can add attachments to and delete attachments from applications with a Status field value of Saved, Submitted, or Rejected. You cannot add attachments to and delete attachments from applications with a Status field value of Cancelled or Processed. If you want to add an attachment after an application is processed, then add the attachment to the appropriate case record. For more information, see Adding Attachments to Cases.

This task is a step in Process of Managing Applications.

To add an attachment to an application

Navigate to the Applications screen.
To view only the submitted applications assigned to you, select My Applications in the visibility filter.
Additional selections in the visibility filter display applications for your team, applications for an organization, and all applications. Applications newly assigned to you have a star icon in the New field of the Applications list.
Drill down on the Name field of the application.
In the Application Attachments view, click New File or New URL to associate a document or other media with the application.

Viewing Master Cases

A master case is a portfolio that contains all of the benefits cases for a family. All of the benefits cases for a family are associated with the primary contact for that family, the head of household. This contact record is associated with a single master case, and a master case is associated with a single contact.

By default, cases for the benefit category are associated with master cases. However, by default, cases for nonbenefit categories, such as investigation, immigration, and tax, are not associated with master cases. Administrators must configure this association. For more information about this configuration, see Associating Manually Created Cases with Master Cases.

Because a master case provides a holistic view of the cases for a family, an agent who is working on a case for that family can access the master case to see the cases of other agents who are serving that family. An agent can also access this view to determine whether a family applied in the past for the same social service or for different social services that the agency offers. In the Master Case view, you can view (but not change) the activities and calendar for the cases that are associated with a master case.

This task is a step in Roadmap for Managing Benefits Cases.

To view a master case

Navigate to the Contacts screen, then the Contacts List view.

Drill down on the Master Case number (#) field of the contact record for the citizen.

Alternatively, to view a master case, you can drill down on the Last Name field of the contact record, and navigate to the Master Case view. In this view, you cannot add cases to the master case, and you cannot view the activities and calendar for the master case.

The Master Case form appears, and after the form, a list of cases that are associated with the master case appears. The following table describes some of the master case fields and case fields.

Field	Description
Master Case Fields
Name	Displays the name of the master case. This field has the following format: Contact Full Name. If a citizen changes the contact name in a submitted application, then the master case name for the citizen does not change.
Status	Displays the status of the master case in the agency’s processing. Values include: Active. The citizen currently needs agency benefits. Inactive. The citizen no longer needs agency benefits. For example, the citizen is dead.
Master Case #	Displays an automatically generated number that uniquely identifies the master case.
Team	Displays the value in the Team field of the contact record for the master case.
Contact Last Name	Displays the last name of the citizen who is associated with this master case.
Contact First Name	Displays the first name of the citizen who is associated with this master case.
Organization	Displays the organization that is associated with the master case. This field is populated with the value in the Organization field of the contact record for the master case. To change the default value in this field, you can navigate to the contact record for the master case, and change this field in that record.
Description	Displays a description of the master case.
Case Fields
Case Number	Displays an automatically generated number that uniquely identifies the case.
Case Name	Displays the name of the case. For cases that are automatically created from applications submitted on a self-service Web site, this field has the following format: Contact Full Name - Creation Date - Application Number. To view the case, drill down on this field.
Status	Displays the status of the case in the agency’s processing. Values include: Submitted. The case is submitted for manager approval. Rejected. A manager did not approve the case. Active. A manager approved the case, and agents are working on the case. Inactive. A manager approved the case, and agents are no longer working on the case. Closed. The case is closed.
Sub-Status	Displays a further clarification of the case status.
Type	Displays the type of benefits or immigration program applicable to the case. For cases that are automatically created from applications submitted on a self-service Web site, this field has a value of Other, but agents can change this value. Additional values include Food Stamps, Medical Assistance, Cash-Financial Assistance, Child Care, Unemployment, Visa, Passport, and Citizenship.
Category	Displays the category of the case. For social services, this field always is Benefit.
Date Opened	Displays the date and time that the case is created.
Date Closed	Displays the date and time that the case is closed.
First Name	Displays the first name of the citizen who is associated with this case.
Last Name	Displays the last name of the citizen who is associated with this case.
SSN	Displays the social security number of the citizen who is associated with this case.
Team	Displays the user ID of the agent who uploaded the application for the citizen and thus created the case.

To view the activities for the cases that are associated with the master case record, navigate to the Activities view.
To view the calendar for the cases that are associated with the master case record, navigate to the Calendar view.

Disassociating Cases from a Master Case

An agent might want to disassociate (or detach) a case from a group of cases in a master case. For example, if an agent changes the primary contact for a case, then the agent can disassociate that case from its master case because the case no longer relates to this master case. Although a disassociated case no longer appears in the case list for its master case, the disassociated case still appears in the case list on the Cases screen. You cannot disassociate a benefits case from a master case.

This task is a step in Roadmap for Managing Benefits Cases.

To disassociate a case from a master case

Navigate to the Contacts screen, then the Contacts List view.
Drill down on the Master Case number (#) field of the contact record for the citizen.
The Master Case form appears, and after the form, a list of cases that are associated with the master case appears.
In the list of cases, select the case that you want to disassociate from the master case.
Click Disassociate.

Note: The Disassociate button is disabled if the Category field for the case is Benefit.
The case no longer appears in the list of cases.

Updating Benefits Cases

When an agent uploads an application for a citizen, if no applicable case record exists for the citizen, then a case record is automatically created, and if an applicable case record exists for the citizen, then that case record is automatically updated. Agents can update case records from the Master Case view. From this view, agents can access the Cases view, which provides additional views that are applicable to benefits cases.

A created or updated case file can be automatically routed (using Assignment Manager) to a manager for review, or the agent can automatically route the file to a manager for review. For more information about automatic approval routing, see Submitting Cases for Approval and Approving Cases in the Inbox.

This task is a step in Roadmap for Managing Benefits Cases.

To update a benefits case

Navigate to the Contacts screen, then the Contacts List view.
Drill down on the Master Case number (#) field of the contact record for the citizen.
The Master Case form appears, and after the form, a list of cases that are associated with the master case appears.
If you want to add a new case to the master case, then create a new record, and enter the name of the case in the Case Name field.
The Category field of the case is populated with a value of Benefit, but you can change this field. The contact information for the case is populated with the contact information for the master case.
If you want to add data to an existing case, then drill down on the Case Name field of that case, and navigate to the appropriate views in the Case form to add details.

Updating Contact Records

When agents upload an application, they distribute the data in the application to the appropriate data fields for contacts. After application upload, agents might want to change or add information for contacts. For more information about managing contact information, see Siebel Applications Administration Guide.

You can update basic information about contacts, such as addresses and phone numbers, in contact records, and you can update related contact information about expenses, income, financial assets, and relationships using the views that are associated with the contact record. For example, the Relationship Hierarchy view provides a graphical hierarchy of the contact relationships.

This task is a step in Roadmap for Managing Benefits Cases.

To update contact records

Navigate to the Contacts screen, then the Contacts List view.
Drill down on the Last Name field of the contact.
Update the necessary information in the Contact form.
To update more information, complete the following steps:
1. Navigate to the More Info view to update additional fields for the contact.
2. Navigate to the Expenses view to update expense information for the contact, such as mortgages, rent, and utilities.
  You can assign a household expense to any contact in the household. For convenience, you might decide to assign a household expense that applies to all contacts to the primary contact for that household.
3. Navigate to the Income view to update income information for the contact, such as salaries, commissions, and pensions.
4. Navigate to the Financial Assets view to update information about the financial assets for the contact, such as bank accounts, stocks, and bonds.

Using Templates to Assess Benefits

A manager can assign assessment activities to agents on a case team. An activity plan specifies the list of activities or the business processes that agents working on a case must complete. The activity plan for a case might include an assessment activity to determine whether the benefits application is complete. The agent assigned to the activity can use a predefined assessment template to complete the activity.

This task is a step in Roadmap for Managing Benefits Cases.

Administrators set up activity plans with associated activities using the Activity Templates view of the Administration - Data screen, and set up assessment templates with associated attributes using the Sales Assessment Templates view of the Administration - Data screen. For information about creating and using activity and assessment templates, see Siebel Applications Administration Guide.

An assessment includes a set of questions that you can ask to evaluate a case. For example, assessments might include the following questions:

Does the application meet the basic criteria for acceptance?
Did the citizen provide sufficient evidence to support receiving benefits?
Do you need additional evaluations?
Has the case reached a point of closure?

The agent assigned to an assessment activity begins the activity by opening the case record and associating a predefined assessment template with the case using the Assessments view. For information about completing assessments, see Assessing Child-Welfare Incidents.

For those assessments that are more complex, or that require data on a specific form, the agent can create a report and attach the report and supporting documentation to the case record. The agent conducting an assessment of the citizen’s information might verify employment and household information, assets and liabilities, and medical diagnoses. A personal interview with the citizen might be necessary.

Process of Managing Benefits for Cases

This process consists of tasks that users typically perform when managing benefits for cases. Your agency might follow a different process according to its business requirements.

To manage benefits for cases, users perform the following tasks:

This process is a step in Roadmap for Managing Benefits Cases.

Screening Cases for Benefits Eligibility

You can review the available plans and associated benefits that apply to a benefits case for a citizen. In this screening task, you do not actually assign benefits to a case, but instead review the plans and associated benefits for which the citizen is eligible before actual assignment. Working with the citizen, you can add information to and delete information from the case record and then complete this screening task again to see whether the available benefits change. You can delete and then regenerate these screening plans and associated benefits as often as necessary, even after plans and associated benefits are assigned to a case.

You cannot manually add other benefits to these screening plans. You can screen for benefits only the cases that have a Status field of Active and that have at least one contact.

This task is a step in Process of Managing Benefits for Cases.

To screen a case for benefits eligibility

Navigate to the Cases screen, then the Case List view.
Select the case that you want to screen for benefits eligibility.
Click Screening in the Case form.
The plans for which the citizen is eligible appear in the Benefit Plans view in the Plans view of the Cases screen. These plans have a Type field value of Screening and a Status field value of Inactive. The benefits that are associated with these plans appear in the same view. These benefits have a Status field value of Inactive.
(Optional) After reviewing the benefits with the citizen, delete the plan records from the Benefit Plans view.
The associated benefits are also deleted.

Automatically Assigning Benefits to Cases

Agents automatically assign benefits to cases to make sure that the same preconfigured eligibility rules apply to all benefits cases. When you automatically assign benefits to a case, the field values for the plans, associated benefits, and benefit payments are automatically populated. These field values are locked, and you cannot change most of them. After you automatically assign benefits to cases, you can review the detailed information that was used to calculate those benefits. For more information, see Reviewing Details for Benefits Determination.

Although you cannot delete automatically generated plans, associated benefits, and benefit payments, you can add other benefits, change benefit products, and add other benefit payments. Later, you can automatically reassign benefits to the case. For such a reassignment, administrators can configure Oracle Intelligent Advisor to consider or to ignore these added benefits, changed benefit products, and added payments. When you reassign benefits to a case, the data for the plans and associated benefits is archived in the Benefit History view, and not purged.

You can automatically assign benefits only to cases that have a Status field of Active and that have at least one contact.

After the agent assigns benefits to a case, the case can be automatically routed to a manager for review and approval. For more information about automatic approval routing, see Submitting Cases for Approval and Approving Cases in the Inbox.

This task is a step in Process of Managing Benefits for Cases.

To automatically assign benefits to a case

Navigate to the Cases screen, then the Case List view.
Select the case to which you want to automatically assign benefits.
Click Eligibility in the Case form.
The plans that are assigned to the citizen appear in the Benefit Plans view in the Plans view of the Cases screen. These plans have a Type field value of Benefit Plan and a Status field value of Active. The benefits that are associated with these plans and the payments that are associated with those benefits appear in the same view. For more information about the fields in this view, see Manually Assigning Benefits to Cases.

Reviewing Details for Benefits Determination

Benefit plans and associated benefits are automatically assigned to a case in Siebel Public Sector when an agent clicks the Eligibility button or Screening button in the Case form and when an agent uploads a benefits application that a citizen submits on a self-service Web site. To qualify for benefit plans, a household must meet the specific criteria that a social service agency defines.

This task is a step in Process of Managing Benefits for Cases.

Manually Assigning Benefits to Cases

Instead of automatically assigning benefits to a case, an agent might temporarily manually assign benefits to the case because of emergency or other non-routine considerations. When you manually assign benefits to a case, you enter values in the fields for the plans, associated benefits, and benefit payments. An application that determines benefits does not populate these field values.

Later, you can automatically assign benefits to the case. For this assignment, administrators can configure Oracle Intelligent Advisor to consider the data for the manual plans, associated benefits, and benefit payments or to ignore this data. When you reassign benefits to a case, the data for existing manual plans and associated benefits is archived in the Benefit History view, and not purged.

You can create (or update) a benefit plan only for cases that have a Status field that is not Closed or Inactive. To associate benefits with a benefit plan, the benefits case must have at least one contact.

After the agent assigns benefits to a case, the case can be automatically routed to a manager for review and approval. For more information about automatic approval routing, see Submitting Cases for Approval and Approving Cases in the Inbox.

This task is a step in Process of Managing Benefits for Cases.

To manually assign benefits to a case

Navigate to the Cases screen, then the Case List view.
Drill down on the Case Name field of the case to which you want to manually assign benefits.
Navigate to the Plans view, then the Benefit Plans view.

In the Benefit Plans list, create a new record, and complete the fields as appropriate.

Note: If you delete a plan record, then the associated records in the Benefits list and Payments list are also deleted, but the associated records in the Orders view (in the Plans view of the Cases screen) are not deleted. For these order records, the values in the Benefit field and the Benefit Id field are cleared.

The following table describes some of the fields.

Field	Description
Plan Name	Displays the name of the primary contact for the benefits case, but you can change this value to another benefit plan name.
Status	Displays a status of Active for the benefit plan. Values include Pending, Approved, Active, Inactive, and Archived. After you click the Eligibility button to automatically create benefit plans, the Status field of those plans is Active. If you change the Status field of a benefit plan to Inactive, then the plan record, associated benefit records, and benefit payment records become read-only, but you can change the Status field of the benefit plan.
Type	Displays the type of benefit plan according the plan creation method as follows: If you navigate to the Cases screen, then the Case List view, and click Screening in the Case form to create the plan, then this field value is Screening. If you navigate to the Cases screen, then the Case List view, and click Eligibility in the Case form to create the plan, then this field value is Benefit Plan. If you manually create the plan as described in this topic, then this field value is Benefit Plan. If you navigate to the Cases screen, then the Case List view, drill down on the Case Name field of a case, navigate to the Plans view, then the Service Plans view, and click Create Benefit in the Activities list to create the plan, then this field value is Service Plan. You cannot change this field value.
Program	Select the name of the program for the benefit plan. You cannot select a value of Service Plan in this field. This value is automatically populated in this field the first time that you create a benefit for a service plan that is associated with the case. You cannot change this Service Plan value. For more information, see Creating Service Plans for Cases. Administrators set up programs in the Program Benefits Administration view of the Administration - Case screen. For more information, see Setting Up Benefits Programs and Setting Up Benefits for Service Plans.
Created Date	Displays the date and time that you create the benefit plan record.
Effective Date	Select the date and time that the benefit plan is in effect.
Locked	Displays no check in the check box when you manually create a plan. Displays a check in the check box when you automatically generate a plan. You cannot change this field. Automatically generated plans are locked so that users cannot change the predetermined information in those plans. However, users can change the Status field in locked plans.
Expiration Date	Select the date and time that the benefit plan is no longer in effect.
Comments	Type relevant information about the benefit plan.

In the Benefits list, create new records for the plan, and complete the fields as appropriate.

Note: If you delete a benefit record, then the associated records in the Payments list are also deleted, but the associated records in the Orders view (in the Plans view of the Cases screen) are not deleted.

The following table describes some of the fields.

Field	Description
Benefit Name	Select the name of the benefit in the program. You can select only benefits that are associated with the program. Administrators associate benefits with programs in the Program Benefits Administration view of the Administration - Case screen.
Benefit Id	Displays an automatically generated number that uniquely identifies the benefit.
Product	Displays the specific product or service for the benefit. You can change this field value even if you automatically assign benefits to cases. You can select a value in this field if the Type field in the Benefits list is Product or Service. Administrators associate products with benefits in the Program Benefits Administration view of the Administration - Case screen, but you can click the Show All button in the Pick a Product dialog box to select a product that is not associated with the benefit. To see the attributes that are associated with the selected product, select Attributes in the visibility filter (next to the Benefits list). Administrators associate attributes with products in the Administration - Product screen, but you can change the Value fields for attributes. For more information about products, see Siebel Product Administration Guide.
Status	Displays a status of Pending for the benefit. Values include Pending, Approved, In Progress, Inactive, Cancelled, and Completed. After you click the Eligibility button to automatically create benefits, the Status field of those benefits is Pending. You can update only benefits with a Status field value of Pending, Approved, In Progress, or Inactive.
Amount	Type the monetary amount of the benefit if the Type field in the Benefits list is Cash or Cash Equivalent. When you click the select button in this field, you can select a currency code and an exchange date for the amount.
Frequency	Select a denotation of how often the citizen receives the benefit. Values include Daily, Weekly, Monthly, and One-Time.
Start Date	Select the date and time that the benefit is in effect. This field value must be between the field value for the Effective Date field and the Expiration Date field of the associated benefit plan record.
End Date	Select the date and time that the benefit is no longer in effect. This field value must be between the field value for the Effective Date field and the Expiration Date field of the associated benefit plan record.
Locked	Displays no check in the check box when you manually assign a benefit to a plan. Displays a check in the check box when you automatically generate a plan. You cannot change this field. Automatically generated benefits are locked so that users cannot change the predetermined benefits in available plans. However, users can change the Status field in locked benefits.
Unit of Measure	Select the unit of measure for the value in the Qty field.
Last Name	Displays the last name of the primary contact for the benefits case, but you can change this value to the last name of the citizen who receives the benefit. You can select only the citizens who are associated with the benefits case. If multiple citizens are associated with the benefits case, and if each of these citizens receives this benefit, then create a separate benefit record for each citizen. You can drill down on this field, and then navigate to the Benefits view in the Contacts List to see all benefits for this citizen.
First Name	Displays the first name of the citizen who receives the benefit.
Relationship to Primary Contact	Select the relationship of the citizen who receives the benefit to the primary contact for the case. Values include Child and Spouse.
Qty	Type the number of items in the benefit if the Type field in the Benefits list is Product or Service.
Type	Select the type of benefit. Values include: Cash. Benefits of this type include payments for disability insurance, unemployment insurance, and social security. Cash Equivalent. Benefits of this type include food stamps and transportation vouchers. Product. Benefits of this type include wheelchairs and other special equipment for disabled individuals. Service. Benefits of this type include child care, job training, and drug or family counseling.
Order #	Displays an automatically generated number that uniquely identifies the referral order for a benefit that is a product or service. You can drill down on this field to see the Line Items view for the order in the Service Orders screen. If you delete or cancel the referral order, then this field is cleared. For more information about creating referral orders, see Siebel Partner Relationship Management Administration Guide.
Provider	Select the service provider, if any, that supplies the benefit. In the dialog box that appears when you click the select button in this field, you see all accounts with a Status field of Active. In the dialog box, the accounts for service providers have a check in the Service Provider field. You can designate field values to find an appropriate account. To see more information about a service provider, navigate to the Service Providers screen, and then the Service Provider List view.

In the Payments list, create new records for each benefit, and complete the fields as appropriate.

Note: You normally create payment records only for benefits with a Type field of Cash or Cash Equivalent. To see the Payments list, select Payments in the visibility filter (next to the Benefits list).

The following table describes some of the fields.

Field	Description
Payment #	Displays an automatically generated number that uniquely identifies the benefit payment.
Payment Date	Select the date that the benefit payment was made or will be made.
Amount	Type the monetary amount of the benefit payment.
Payment Method	Select the payment method for the benefit payment. Values include Cash, Check, Direct Deposit, and Wire Transfer.
Type	Select the type of payment. Values include Expense, Disbursement, Refund, and Reimbursement.
Payee	Displays the name of the citizen who receives the benefit payment. You can select only citizens who are associated with the benefits case.
Status	Displays a status of Pending for the benefit payment. Values include Pending, Approved, Rejected, Inactive, Cancelled, Submitted-Pending, Processed, Request Failed, and Paid. After you click the Eligibility button to automatically create payments, the Status field of those payments is Pending. Payments with a Status field of Processed or Paid are read-only.
Locked	Displays no check in the check box when you manually assign a payment to a benefit. Displays a check in the check box when you automatically generate a plan. You cannot change this field. Automatically generated benefit payments are locked so that users cannot change the predetermined payments for available benefits. However, users can change the Status field, Payment Method field, and Comments field in locked payments.
Payment Profile Name	Select a payment profile for the benefit payment. This profile identifies the bank, branch, and account number for the benefit payment. You can select a value in this field only if you select a value of Direct Deposit or Wire Transfer in the Payment Method field. Only payee payment profiles with a value of Active in Profile Status field are available for selection in this field. For more information, see Setting Up Payment Profiles.
Comments	Type relevant information about the benefit payment.

To see the attributes for a product in a benefit, select the benefit in the Benefits list, and then select Attributes in the visibility filter (next to the Benefits list).
You cannot delete these attributes.

Setting Up Payment Profiles

Before benefits are paid to a citizen, an agent can set up payment profiles for the citizen. Profiles include information about the citizen’s bank accounts. Agents can associate these bank accounts with the citizen’s benefit payments so that the accounts payable application can deposit the payments directly into these bank accounts.

This task is a step in Process of Managing Benefits for Cases.

To set up a payment profile

Navigate to the Contacts screen, then the Contacts List view.
Drill down on the Last Name field of the contact for which you want to set up a payment profile.
Navigate to the Payment Profile view.

Create a new record, and complete the fields as appropriate.

The following table describes some of the fields.

Field	Description
Payment Profile Name	Type a name for the payment profile.
Bank Account Number	Type the number for the citizen’s bank account.
Branch Name	Select the branch name for the citizen’s bank account. Additional fields for the payment profile, such as the fields for the bank name, the bank ID, the branch ID, the routing number, and the branch address, are populated when you select a branch name. You can create the branch records to select in the Accounts List view of the Accounts screen. When you create a branch record in this view, select Banking in the Account Type field, the parent bank for the branch in the Parent field, and Active in the Status field. If you select a branch record for a payment profile and change the fields that contain branch information for the branch record in the Accounts List view, then the fields are automatically changed for the payment profile.
Profile Status	Displays a value of New. You can change this value to Active or Inactive.
SWIFT Code	Displays the SWIFT (Society for Worldwide Interbank Financial Telecommunication) code when you select a value in the Branch Name field. This code identifies the bank branch for international payment transactions.

Processing Benefit Payments

After a benefit payment amount is determined, an agent can forward payment data for the benefit to an accounts payable application. For more information, see About Integrating Siebel Public Sector with Accounts Payable.

When a citizen is paid, the Status field of the payment changes to Paid. When a payment is processed, the Payment number (#) field of the payment is populated. You cannot process more than one benefit payment at a time. Also, you can process a benefit payment only if the Status field in the payment record is Pending or Approved.

This task is a step in Process of Managing Benefits for Cases.

To process a benefit payment

Navigate to the Cases screen, then the Case List view.
Drill down on the Case Name field of the case for which you want to process a benefit payment.
Navigate to the Plans view, then the Benefit Plans view.
In the Payments list, select the payment that you want to process, and click Send Payment.
The Status field of the payment changes to Submitted-Pending.

Viewing Payments for Benefits Cases

An agent can review, but not change, the past and future benefit payments for a benefits case in the Payments view. The Payments view shows both the payments that agents manually create and the payments that are associated with benefits that another application determines.

This task is a step in Process of Managing Benefits for Cases.

To view the payments for a benefits case

Navigate to the Cases screen, then the Case List view.
Alternatively, you can navigate to the Payments screen, then the Benefit Payments view.
Drill down on the Case Name field of the case for which you want to view the benefit payments.
Navigate to the Plans view, then the Payments view.
The payments for the benefits case appear. For more information about the fields this view, see Manually Assigning Benefits to Cases.

Checking for Necessary Benefits Reassignments

After benefits are automatically assigned to a case, the agent or another user can change the citizen data that determines those benefits. They might change this data in the view for the case or in another screen or view that affects data for the case. When data that determines benefits changes, the agent can reassign the benefits to the citizen’s case.

To determine whether changes to citizen data affect the benefits for the citizen’s case, the agent clicks the Scan Changes button. After determining that the relevant data is changed, the agent must reassign benefits to the case. The processing that occurs when the agent clicks this button evaluates changed data in only the fields and records that are implemented for effective date tracking. For more information, see Implementing Effective Date Tracking.

Note: The Scan Changes button is enabled only for cases that have a Status field of Active and a Category field of Benefit.

This task is a step in Process of Managing Benefits for Cases.

To check for necessary benefits reassignment

Navigate to the Cases screen, then the Case List view.
Select the active case for which you want to check for necessary benefits reassignment.
Click Scan Changes.
A check appears in the Info Changed field of the case if the data that determines benefits changed after an agent last automatically assigned benefits to the case. A check also appears in the Info Changed field of additional cases if this data change also affects the benefits for those cases.

Reassigning Benefits to Cases

An agent can change the information in a benefits case when the citizen’s circumstances change or when the criteria for eligibility in established plans change. These changes might affect the plans for which the citizen is eligible. If the plans and associated benefits are automatically generated, then you can regenerate the plans and associated benefits after you adjust the information in the benefits case.

When you reassign benefits to a case, Siebel Public Sector performs the following steps:

If the case changes affect the benefits for the citizen’s plans, then copies the information about the plans and associated benefits to the Benefit History view, and updates the existing plans and associated benefits to reflect the new data for the citizen.
For benefit records that have no associated payment records with a status of Processed or Paid, deletes the benefit records and the associated payment records. For benefit records that have associated payment records with a status of Processed or Paid, cancels the benefit records, and deletes other associated payment records without a status of Processed or Paid.
Retains benefit payment records with a status of Processed or Paid. If any of these payments are recalculated, then recognizes the difference between the prior payment and the recalculated payment as a new payment record with a positive amount for payments that increase or negative amount for payments that decrease. Updates the status of these new payment records to Pending.
Deletes benefit payment records without a status of Processed or Paid if the records no longer apply to the case. If the records still apply to the case, then changes the status to Pending, and adjusts the records if necessary.
Creates new benefit payment records if necessary, and assigns a status of Pending to these records.
Clears the check in the Info Changed field of the case.
Regenerates a new decision report in the Decision Report view in the Plans view in the Case List view of the Cases screen.

This task is a step in Process of Managing Benefits for Cases.

To reassign benefits to a case

Navigate to the Cases screen, then the Case List view.
Select the case for which you want to reassign benefits.
Click Eligibility in the Case form.

Viewing the Benefit History for Benefits Cases

After an agent reassigns benefits to a case, the plans and associated benefits that existed before reassignment are archived in the Benefit History view. Payments for archived plans are not archived in this view but included in the active plans.

Agents can review, but not change, the benefit history for a case in the Benefit History view. The Benefit History view includes archived plans that are no longer in effect because the circumstances for the plan contacts changed. This view can also include expired plans that are no longer in effect because the plans were completely executed.

This task is a step in Process of Managing Benefits for Cases.

To view the benefit history for a benefits case

Navigate to the Cases screen, then the Case List view.
Drill down on the Case Name field of the case for which you want to view benefits history.
Navigate to the Plans view, then the Benefit History view.
The benefit history for the benefits case appears.

Creating Orders for Benefits Cases

An agent can create an order for a benefits case. The Status field of the benefits case must be Active to create an order. If you delete a benefits case for which you create an order, then the order still appears in the Service Orders screen. For more information about creating orders, see Siebel Order Management Guide.

The Orders view for a benefits case includes all orders for the benefits case. These orders include:

The orders that are not related to benefits and to third-party service providers. Users create these orders using the procedure in this topic.
Referral orders that users create for the benefits in a case. For more information about creating a referral order for a benefit in a case, see Siebel Partner Relationship Management Administration Guide.

Note: If you are not using Siebel Order Management, then the administrator must disable the workflows and signals that relate to pricing functionality so that error messages do not appear when you add products to orders.

This task is a step in Roadmap for Managing Benefits Cases.

To create an order for a benefits case

Navigate to the Cases screen, then the Case List view.
Drill down on the Case Name field for the benefits case for which you want to create an order.
Navigate to the Plans view, then the Orders view.

Create a new record, and complete the fields as appropriate.

The following table describes some of the fields.

Field	Description
Order #	Displays an automatically generated number that uniquely identifies the order.
Revision	Displays the version number of the order. When you create an order, this field is populated with a value of 1. This number is increased by 1 each time that you revise the order. For information about revising orders, see Siebel Order Management Guide.
Type	Select the type of order.
Status	Select the status of the order. When you create an order, this field is populated with a value of Pending, but you can change this value. When the Benefit Id field contains data, you cannot change the Status field value if that value is Closed or Inactive.
Priority	Select the priority of the order. When you create an order, this field is populated with a value of Medium, but you can change this value.
Order Date	Select the date and time for the order. When you create an order, this field is populated with the current date and time, but you can change this value.
Provider	Displays the third-party service provider that supplies a benefit. This field is populated when you create a referral order for a benefit in a case. You cannot select a value in this field when you create an order for a benefits case.
Recipient Last Name	Select the last name of the citizen who receives the benefit for the order.
Recipient First Name	Displays the first name of the citizen who receives the benefit for the order.
Billing Account	Select the billing account for order.
Benefit	Displays the name of a benefit in a program. This field is populated when you create a referral order for a benefit in a case, and cleared when you cancel that order or delete the benefit. You cannot select a value in this field when you create an order for a benefits case.
Case Number	Displays the number of the case that is associated with the order. When you create an order, this field is populated.
Comments	Type relevant information about the order.
Benefit Id	Displays an automatically generated number that uniquely identifies a benefit in a program. This field is populated when you create a referral order for a benefit in a case, and cleared when you cancel that order or delete the benefit. This field is not populated when you create an order for a benefits case.

Drill down on the Order number (#) field for the new order.
The Line Items view of the Service Orders screen appears for the order.
Create a new record for each product that you want to include in the order, and complete the fields as appropriate.
You can designate the attributes for the products in the Attributes view of the Line Items view.

Process of Managing Service Plans for Cases

This process consists of tasks that users typically perform when managing service plans for cases. Your agency might follow a different process according to its business requirements.

To manage service plans for cases, users perform the following tasks:

This task is a step in Roadmap for Managing Benefits Cases.

Creating Service Plans for Cases

An agent creates a service plan to track the service goals and related activities for a case. A service plan represents an agreement between the agent and one or more contacts who are associated with the case. For example, an agent can work with a parent in a child-welfare case to create a service plan to meet the needs of the child.

This task is a step in Process of Managing Service Plans for Cases.

To create a service plan for a case

Navigate to the Cases screen, then the Case List view.
Drill down on the Case Name field of the case.
Navigate to the Plans view, then the Service Plans view.

In the Service Plans list, create a new record, and complete the fields as appropriate.

The following table describes some of the fields.

Field	Description
Plan Number	Displays an automatically generated number that uniquely identifies the service plan.
Plan Name	Type the name of the service plan.
Plan Category	Select the program for the service plan. Values include Child Welfare, Eligibility, TANF (Temporary Assistance for Needy Families), and Unemployment Insurance.
Plan Type	Select the type of plan. The values that you can select depend on the value that you select in the Plan Category field.
Plan Status	Displays a status of Active for the service plan. Values include Active, Pending, and Completed.
Last Name	Select the last name of the citizen who the plan services. You can select only the contacts that are associated with the case.
First Name	Displays the first name of the citizen who the plan services.
Created Date	Displays the date and time that you create the service plan.
Start Date	Select the date and time that the service plan is in effect.
Expiration Date	Select the date and time that the service plan is no longer in effect.
Created By	Displays your user ID

In the Service Plan Goals list, create a new record, and complete the fields as appropriate.

The following table describes some of the fields.

Field	Description
Name	Type the name of the goal in the service plan. If you enter no data in this field, then after you save the goal record, this field is populated with the service plan name followed by the name of the template that you select, but you can change this value.
Template	Select a predefined activity plan that contains the activities that are associated with the goal. When you save the goal record, the Activities list is populated with the activities for the template. When you set up an activity plan for a service plan, you select Service Plan in the Type for the activity plan. For information about setting up an activity plan, see Siebel Applications Administration Guide.
Planned Start	Select the date and time that you plan to begin work on the goal.
Planned End	Select the date and time that you plan to end work on the goal.
Description	Displays the description of the template that you select, but you can change this value.
Status	Displays a status of Active for the goal.
Lock Assignment	Select this check box if you do not want Assignment Manager to assign this goal to another user.

(Optional) In the Activities list, create additional activity records.
The records in this Activities list do not appear in the calendar.

Assigning Benefits to Service Plans

Frequently, agents assign benefits directly to a benefit plan for a case. However, agents can also create a service plan for the case, and then assign benefits to an activity in that service plan. In this case, a benefit plan record for the case is automatically created for the service plan record, and the benefit that the agent assigns to the activity is automatically associated with that benefit plan.

You can access this benefit plan record in the Benefit Plans view in the Plans view in the Case List view of the Cases screen, and adjust or delete the benefit plan, adjust or delete the associated benefit, create additional benefits, and create orders and payments for the benefits. Any changes that you make to the benefit plan record in this view are automatically reflected in the service plan record in the Service Plans view in the Plans view in the Case List view of the Cases screen.

If an activity in a service plan is already associated with a benefit, then you cannot assign another benefit to the activity. You must delete the benefit before you can create a new benefit for the activity. You can also create a new activity or select another activity in the service plan, and assign the other benefit to that activity.

After you assign a benefit for a benefits case contact to an activity in a service plan, you cannot assign the same benefit for the same benefits case contact to another activity in the service plan. However, you can assign the same benefit for a different benefits case contact to the other activity.

This task is a step in Process of Managing Service Plans for Cases.

To assign a benefit to a service plan

Navigate to the Cases screen, then the Case List view.
Drill down on the Case Name field of the case.
Navigate to the Plans view, then the Service Plans view.
In the Service Plans list, select the appropriate service plan, and in the Service Plan Goals list, select the appropriate service plan goal.

Note: You assign benefits only to activities in service plans that have a Plan Status field value of Active, Pending, or Approved.
In the Activities list, select the activity record to which you want to assign a benefit, and click Create Benefit.

In the Benefit dialog box, complete the fields as appropriate.

The following table describes some of the fields.

Field	Description
Benefit Name	Select the name of the benefit in the service plan. You can select only benefits that are associated with the service plan. Administrators associate benefits with service plans in the Program Benefits Administration view of the Administration - Case screen. For more information, see Setting Up Benefits for Service Plans.
Frequency	Select a denotation of how often the citizen receives the benefit. Values include Daily, Weekly, Monthly, and One-Time.
Last Name	Displays the last name of the primary contact for the benefits case, but you can change this value to the last name of the citizen who receives the benefit. You can select only the citizens who are associated with the benefits case. If multiple citizens are associated with the benefits case, and if each of these citizens receives this benefit, then create a separate benefit record for each citizen.
First Name	Displays the first name of the citizen who receives the benefit.
Start Date	Select the date and time that the benefit is in effect. This field value must be between the field value for the Start Date field and the Expiration Date field of the associated service plan record.
End Date	Select the date and time that the benefit is no longer in effect. This field value must be between the field value for the Start Date field and the Expiration Date field of the associated service plan record.
Type	Select the type of benefit. Values include: Cash. Benefits of this type include payments for disability insurance, unemployment insurance, and social security. Cash Equivalent. Benefits of this type include food stamps and transportation vouchers. Product. Benefits of this type include wheelchairs and other special equipment for disabled individuals. Service. Benefits of this type include child care, job training, and drug or family counseling.

Click OK.
The following updates occur:
- The Benefit field for the activity is populated with a value. You cannot delete the activity if you cannot delete the benefit that is associated with the activity. For information about the conditions under which you cannot delete a benefit record, see Operation Controls for Benefit Data.
  
  Note: In the Activities view of the Cases screen or in the Activities screen, you are allowed delete activity records that you cannot delete in the Activities list in the Service Plans view in the Plans view of the Cases screen. Be careful not to delete such activity records.
- The Benefit Status field for the activity is populated with a value of Pending. You cannot delete the activity when this field has a value of Pending, In Progress, Approved, or Completed.
  If you cannot delete a child activity for a goal, then you cannot delete the goal.
- If no other benefits were previously assigned to the service plan, then a service plan record now also appears in the Benefit Plans view in the Plans view of the Cases screen. For this new record, the value in the Program field and the Type field is Service Plan.

Changing Data in Effective Dating Fields

To change data for effective dating fields, perform the following tasks:

This task is a step in Roadmap for Managing Benefits Cases.

Changing Values in Effective Dating Fields

For the fields that administrators set up as effective dating fields, agents can select the effective date of the field value change. Also, fields that are populated with data received from an external application, such as a self-service Web site, can have an effective date of the field value change. For more information about working with effective dating for field values, see About Effective Dating for Field Values and Records.

To change a value in an effective dating field

Navigate to the appropriate screen or view.
Click the field for which you want to change the value.
An effective date button appears in the field.
When administrators implement effective date tracking, they determine whether you can change the value in an effective dating field without clicking the effective date button. For more information about setting up editing of effective dating fields, see Implementing Effective Date Tracking.
If you can change the value in the field without clicking the effective date button, then complete the following steps:
1. Change the value in the field.
  If the Status field is enabled for the field, then the field value does not change when you save the record that contains the field value because the entry for the changed field value in the Effective Date dialog box has a Status field value of Pending.
2. Click the effective date button.
  - If the Status field is disabled for the field, then the Effective Date dialog box appears showing an entry for the prior field value with an effective end date and an entry for the new field value with an effective start date.
  - If the Status field is enabled for the field, then the Effective Date dialog box appears showing an entry for the prior field value with a Status field value of Approved and an entry for the new field value with a Status field value of Pending.
3. (Optional) Change the date range for the entry for the prior field value and the new field value.
  - If the Status field is disabled for the field, then the order in which you change the date range for these entries is important. You see an error message if the date range for first entry that you change overlaps the date range of the other entry.
  - If the Status field is enabled for the field, then you cannot change the date range for the entry for the prior field value unless you have the authority to do so.
4. Click Close to close the Effective Date dialog box.
If you must click the effective date button to change the value in the field, then complete the following steps:
1. Click the effective date button.
  The Effective Date dialog box appears.
2. Create a new entry.
3. In the new dialog box that appears, enter the value for the field, select the starting date for the field value, and save your changes.
  - If the Status field is disabled for the field, then the Effective Date dialog box appears again showing an entry for the prior field value with an effective end date and an entry for the new field value with an effective start date.
  - If the Status field is enabled for the field, then the Effective Date dialog box appears showing an entry for the prior field value with a Status field value of Approved and an entry for the new field value with a Status field value of Pending.
4. (Optional) Change the date range for the entry for the prior field value and the new field value.
  - If the Status field is disabled for the field, then the order in which you change the date range for these entries is important. You see an error message if the date range of first entry that you change overlaps the date range of the other entry.
  - If the Status field is enabled for the field, then you cannot change the date range for the entry for the prior field value unless you have the authority to do so.
5. Click Close to close the Effective Date dialog box.

Deleting Values in Effective Dating Fields

For the fields that administrators set up as effective dating fields, agents can select the effective date of the field value deletion. Also, fields that are populated with data received from an external application, such as a self-service Web site, can have an effective date of the field value deletion. For more information about working with effective dating for field values, see About Effective Dating for Field Values and Records.

Note: Do not delete a value in an effective dating field by selecting an entry in the Effective Date dialog box and deleting the entry in that dialog box. Instead, follow the procedure in this topic. Delete an entry in the Effective Date dialog box only to purge field value history.

To delete a value in an effective dating field

Navigate to the appropriate screen or view.
Click the field for which you want to delete the value.
An effective date button appears in the field.
When administrators implement effective date tracking, they determine whether you can delete the value in an effective dating field without clicking the effective date button. For more information about setting up editing of effective dating fields, see Implementing Effective Date Tracking.
If you can delete the value in the field without clicking the effective date button, then complete the following steps:
1. Clear the value in the field.
  If the Status field is enabled for the field, then the field value is not deleted when you save the record that contains the field value because the entry for the new blank field value in the Effective Date dialog box has a Status field value of Pending.
2. Click the effective date button.
  - If the Status field is disabled for the field, then the Effective Date dialog box appears showing an entry for the prior field value with an effective end date and an entry for the new blank field value with an effective start date.
  - If the Status field is enabled for the field, then the Effective Date dialog box appears showing an entry for the prior field value with a Status field value of Approved and an entry for the new blank field value with a Status field value of Pending.
3. (Optional) Change the date range for the entry for the prior field value and the new blank field value.
  - If the Status field is disabled for the field, then the order in which you change the date range for these entries is important. You see an error message if the date range for first entry that you change overlaps the date range of the other entry.
  - If the Status field is enabled for the field, then you cannot change the date range for the entry for the prior field value unless you have the authority to do so.
4. Click Close to close the Effective Date dialog box.
If you must click the effective date button to delete the value in the field, then complete the following steps:
1. Click the effective date button.
  The Effective Date dialog box appears.
2. Create a new entry.
3. In the new dialog box that appears, do not enter a value for the field, select the starting date for the blank field value, and save your changes.
  - If the Status field is disabled for the field, then the Effective Date dialog box appears again showing an entry for the prior field value with an effective end date and an entry for the new blank field value with an effective start date.
  - If the Status field is enabled for the field, then the Effective Date dialog box appears again showing an entry for the prior field value with a Status field value of Approved and an entry for the new blank field value with a Status field value of Pending.
4. (Optional) Change the date range for the entry for the prior field value and the new blank field value.
  - If the Status field is disabled for the field, then the order in which you change the date range for these entries is important. You see an error message if the date range of first entry that you change overlaps the date range of the other entry.
  - If the Status field is enabled for the field, then you cannot change the date range for the entry for the prior field value unless you have the authority to do so.
5. Click Close to close the Effective Date dialog box.

Verifying Changes to Effective Dating Fields

When an agent creates an entry for a field value in the Effective Date dialog box, the Status field, if it appears for the field in the dialog box, is automatically populated with a value of Pending. If administrators enable the Status field for an effective dating field, then the Status field appears in the Effective Date dialog box for the field. For more information about enabling the Status field for an effective dating field, see Implementing Effective Date Tracking.

For the Status field value of Pending, the rules engine does not use the field value to determine benefits when benefit plans are generated for the case. If an agent changes the Status field value to Rejected or Cancelled, then the rules engine still does not use the field value to determine benefits. If an agent changes the Status field value to Approved, then the rules engine uses the field value to determine benefits. Only agents with the proper authority can change the Status field value to Cancelled or Approved. Administrators set up this authority when they implement effective date tracking. For more information about setting up this authority, see Implementing Effective Date Tracking.

Before changing a Status field value, an agent with the proper authority verifies the field value. This verification might involve reviewing supporting documentation for the field value or contacting people to check the validity of the field value. After verifying the field value, the agent performs the procedure in this topic to complete the verification.

To verify a change to an effective dating field

Navigate to the appropriate screen or view.
Click the field for which you want to verify a value.
An effective date button appears in the field.
Click the effective date button in the field.
In the Effective Date dialog box that appears, change the value in the Status field of the entry for the changed field value as follows:
- If you cannot verify the field value, or if you do not want to approve the field value, then select a Status field value of Rejected.
- If you can verify the field value, or if you want to approve the field value, then select a Status field value of Approved.
- If you want to retain the field value without rejecting or approving it, then select a Status field value of Cancelled.
Click Close to close the Effective Date dialog box.
After you close the dialog box when you approve the entry for a changed field value, an attempt is made to adjust the date range of the prior approved entry so that this date range does not overlap the date range of the new approved entry. If this attempt fails, then the Conflicting Approval Records dialog box appears showing prior approved entries with date ranges that overlap the date range of the new approved entry.
If the Conflicting Approval Records dialog box appears, then complete either of the following steps:
- To change the Status field value to Cancelled for the prior approved entries with date ranges that overlap the date range of the new approved entry, click Auto Align, and then close the Effective Date dialog box.
  Additional approved entries might be created for the parts of the date ranges of the prior approved entries that do not overlap the date range of the new approved entry.
- To return to the Effective Date dialog box, click Cancel Auto Align.
  In the Effective Date dialog box, you can change the Status field value of the new approved entry, you can delete that entry, or you can change the date range for that entry.

Designating Deletion Authority for Approved Entries for Field Values

To delete an entry with a Status field value of Approved in the Effective Date dialog box, an agent without the proper deletion authority must select the Allow Delete check box for the entry. This selection designates that agents with the proper authority can delete the entry. Administrators set up this authority when they implement effective date tracking. For more information about setting up this authority, see Implementing Effective Date Tracking.

You delete an approved entry for a field value to purge history from the Effective Date dialog box. You do not delete such an entry to delete a field value from an effective dating field. For more information about deleting a field value from an effective dating field, see Deleting Values in Effective Dating Fields.

Note: The Allow Delete check box is not used in application processing, and it does not affect the behavior of the Siebel Public Sector application. Selection of this check box indicates to agents with proper authority that they can delete the entry.

To designate the deletion authority for an approved entry for a field value

Navigate to the appropriate screen or view.
Click the field for which you want to designate the deletion authority for an approved entry.
An effective date button appears in the field.
Click the effective date button in the field.
In the Effective Date dialog box that appears, select the Allow Delete check box for the approved entry.
Click Close to close the Effective Date dialog box.
Instruct an agent with the proper authority to delete the entry for the field value.

Viewing the History for Values in Effective Dating Fields

When you click the effective date button for a field in a record, you can view the history of values for that field. Using the procedure in this topic, you can view the history of values for all effective dating fields in the record. This procedure applies to the fields for the preconfigured business components for income, expenses, financial assets, contacts, and households.

To view the history for values in effective dating fields

To view the history of fields for income, expenses, and financial assets, complete the following steps:
1. Navigate to the Contacts screen, then the Contacts List view.
2. Drill down on the Last Name field of the contact record that contains the effective dating fields that you want to view.
3. Navigate to one of the following views:
  - Income
  - Expense
  - Financial Assets
4. Select a record in the view, and scroll down to the history list in the view.
To view the history of contact fields, complete the following steps:
1. Navigate to the Contacts screen, then the Contacts List view or to the Contacts view of another screen.
2. Drill down on the Last Name field of the contact record that contains the effective dating fields that you want to view.
3. Navigate to the Contact History view.
To view the history of household fields, complete the following steps:
1. Navigate to the Households screen, then the List view or to the Households view of another screen.
2. Drill down on the Name field of the household record that contains the effective dating fields that you want to view.
3. Navigate to the Household History view.

Changing Data in Effective Dating Records

To change data for effective dating records, perform the following tasks:

This task is a step in Roadmap for Managing Benefits Cases.

Adding Effective Dating Records

For the records that administrators set up as effective dating records, agents can select the effective date of the record addition. Also, records that are added because of data received from an external application, such as a self-service Web site, can have an effective date of the record addition. For more information about working with effective dating for records, see About Effective Dating for Field Values and Records.

To add an effective dating record

Navigate to the appropriate view.
Only active records appear in the view.
Create a new record, and complete the fields as appropriate.
If the Status field is enabled for the record, then the record does not appear in the view when you select Show Active Records in the view menu because the entry for the added record in the Link History dialog box has a Status field value of Pending.
(Optional) To change the date range of the added record, complete the following steps:
1. Select Show All Records in the view menu.
2. Select the record, and click Link History.
  The Link History dialog box appears showing an entry for the record with an effective start date. If the Status field is enabled for the record, then the Status field for the entry has a value of Pending.
3. Change the date range for the entry.
4. Click Close to close the Link History dialog box.

Deactivating Effective Dating Records

For the records that administrators set up as effective dating records, agents can select the effective date of the record deactivation. Also, records that are deactivated because of data received from an external application can have an effective date of the record deactivation. Deactivated records are not deleted from the Siebel Public Sector application, and you can view these records if you select Show All Records in the view menu. For more information about working with effective dating for records, see About Effective Dating for Field Values and Records.

Note: Do not deactivate an effective dating record by selecting an entry in the Link History dialog box and deleting the entry in that dialog box. Instead, follow the procedures in this topic. Delete an entry in the Link History dialog box only to purge record history.

Deactivating Effective Dating Records For Disabled Status Fields

Complete the following procedure to deactivate an effective dating record for which the Status field is disabled.

To deactivate an effective dating record for which the Status field is disabled

Navigate to the appropriate view.
Only active records appear in the view.
Select the record that you want to deactivate, and delete the record.

Note: You might have to select Delete Record in the view menu.
After you click OK for the message to confirm the deletion, the record is inactive and no longer appears in the view for active records.
(Optional) To change the date range of the deactivated record, complete the following steps:
1. Select Show All Records in the view menu.
  The deactivated record appears. You cannot add or deactivate records in the Show All mode.
2. Select the deactivated record, and click Link History.
  The Link History dialog box appears showing an entry for the record deactivation with an effective end date.
3. Change the date range for the entry.
4. Click Close to close the Link History dialog box.
(Optional) To reverse a record deactivation, complete the following steps:
1. Select Show All Records in the view menu.
  The deactivated record appears. You cannot add or deactivate records in the Show All mode.
2. Select the deactivated record, and select Undelete Record in the view menu.
3. Select Show Active Records in the view menu.
  The record is added to the view again.
(Optional) To change the date range of a record addition, complete the following steps:
1. Select Show Active Records in the view menu.
2. Select the added record, and click Link History.
  The Link History dialog box appears showing an entry for the record deactivation and an entry for the record addition with an effective start date.
3. Change the date range for the entry for the record addition.
4. Click Close to close the Link History dialog box.

Deactivating Effective Dating Records For Enabled Status Fields

Complete the following procedure to deactivate an effective dating record for which the Status field is enabled. If the Status field is enabled, then you cannot delete the record in the view to deactivate an effective dating record. Also, you cannot select Undelete Record in the view menu to reverse a record deactivation.

To deactivate an effective dating record for which the Status field is enabled

Navigate to the appropriate view.
Only active records appear in the view.
To deactivate the effective dating record, complete the following steps:
1. Select the record you want to deactivate, and click Link History.
  The Link History dialog box appears showing an entry for the record with a Status field value of Approved.
2. Create a new entry.
3. In the new dialog box that appears, select the starting date for the new entry, select the ending date for the new entry, and save your changes.
  The Link History dialog box appears again showing an entry for the record with a Status field value of Approved and the new entry with a Status field value of Pending.
4. (Optional) Change the date range for the new entry.
5. Click Close to close the Link History dialog box.
  The record still appears in the view when you select Show Active Records in the view menu because the entry for the record deactivation has a Status field value of Pending. When an agent with the proper authority changes this Status field value to Approved, the record is deactivated (if the date range of the entry for the record deactivation does not include the current date), and the record no longer appears as an active record.
(Optional) To reverse a record deactivation, complete the following steps:
1. Select Show All Records in the view menu.
  The deactivated record appears. You cannot add or deactivate records in the Show All mode.
2. Select the deactivated record, and click Link History.
  The Link History dialog box appears showing an entry for the record deactivation with a Status field value of Approved.
3. Create a new entry.
4. In the new dialog box that appears, select the starting date for the new entry, and save your changes.
  The Link History dialog box appears again showing an entry for the record deactivation with a Status field value of Approved and the new entry with a Status field value of Pending.
5. (Optional) Change the date range for the new entry.
6. Click Close to close the Link History dialog box.
  The record does not appear in the view when you select Show Active Records in the view menu because the entry for the record addition has a Status field value of Pending. When an agent with the proper authority changes this Status field value to Approved, the record is added again (if the date range of the entry for the record addition includes the current date), and the record appears as an active record.

Verifying Changes to Effective Dating Records

When an agent creates an entry for a record in the Link History dialog box, the Status field, if it appears in the dialog box, is automatically populated with a value of Pending. If administrators enable the Status field for an effective dating record, then the Status field appears in the Link History dialog box for the record. For more information about enabling the Status field for an effective dating record, see Implementing Effective Date Tracking.

For the Status field value of Pending, the rules engine does not use the entry to determine benefits when benefit plans are generated for the case. If an agent changes the Status field value to Rejected or Cancelled, then the rules engine still does not use the entry to determine benefits. If an agent changes the Status field value to Approved, then the rules engine uses the entry to determine benefits. Only agents with the proper authority can change the Status field value to Cancelled or Approved. Administrators set up this authority when they implement effective date tracking. For more information about setting up this authority, see Implementing Effective Date Tracking.

Before changing a Status field value, an agent with the proper authority verifies the entry. This verification might involve reviewing supporting documentation for the entry or contacting people to check the validity of the entry. After verifying the entry, the agent performs the procedure in this topic to complete the verification.

To verify a change to an effective dating record

Navigate to the appropriate view.
Only active records appear in the view.
Select Show All Records in the view menu to show inactive and active records.
The Inactive field is selected for the inactive records and not selected for active records.
Select the inactive record for which you want to verify an entry, and click Link History.
In the Link History dialog box that appears, change the value in the Status field of the entry for the record as follows:
- If you cannot verify the entry, or if you do not want to approve the entry, then select a Status field value of Rejected.
- If you can verify the entry, or if you want to approve the entry, then select a Status field value of Approved.
- If you want to retain the entry without rejecting or approving it, then select a Status field value of Cancelled.
Click Close to close the Link History dialog box.
After you close the dialog box when you approve the entry for a record, an attempt is made to adjust the date range of the prior approved entry so that this date range does not overlap the date range of the new approved entry. If this attempt fails, then the Conflicting Approval Records dialog box appears showing prior approved entries with date ranges that overlap the date range of the new approved entry.
If the Conflicting Approval Records dialog box appears, then complete either of the following steps:
- To change the Status field value to Cancelled for the prior approved entries with date ranges that overlap the date range of the new approved entry, click Auto Align, and then close the Link History dialog box.
  Additional approved entries might be created for the parts of the date ranges of the prior approved entries that do not overlap the date range of the new approved entry.
- To return to the Link History dialog box, click Cancel Auto Align.
  In the Link History dialog box, you can change the Status field value of the new approved entry, you can delete that entry, or you can change the date range of that entry.

Designating Deletion Authority for Approved Entries for Records

To delete an entry with a Status field value of Approved in the Link History dialog box, an agent without the proper deletion authority must select the Allow Delete check box for the entry. This selection designates that agents with the proper authority can delete the entry. Administrators set up this authority when they implement effective date tracking. For more information about setting up this authority, see Implementing Effective Date Tracking.

You delete an approved entry for a record to purge history from the Link History dialog box. You do not delete such an entry to deactivate an effective dating record. For more information about deactivating an effective dating record, see Deactivating Effective Dating Records.

Note: The Allow Delete check box is not used in application processing, and it does not affect the behavior of the Siebel Public Sector application. Selection of this check box indicates to agents with proper authority that they can delete the entry.

To designate the deletion authority for an approved entry for a record

Navigate to the appropriate view.
Only active records appear in the view.
Select the record for which you want to designate the deletion authority for an approved entry, and click Link History.
In the Link History dialog box that appears, select the Allow Delete check box for the approved entry.
Click Close to close the Link History dialog box.
Instruct an agent with the proper authority to delete the entry for the record.

Viewing the History for Effective Dating Records

Using the procedure in this topic, you can view the history of effective dating records.

To view the history for an effective dating record

Navigate to the appropriate view.
Only active records appear in the view.
Select Show All Records in the view menu.
Inactive and active records appear in the view. The Inactive field is selected for inactive records and not selected for active records.
Select the record, and click Link History.
The Link History dialog box appears showing the history of the record.
Close the Link History dialog box.

Process of Managing Appeal Cases

This process consists of tasks that users typically perform when managing appeal cases. Your agency might follow a different process according to its business requirements.

To manage appeal cases, users perform the following tasks:

This process is a step in Roadmap for Managing Benefits Cases.

Accepting or Rejecting Appeal Requests

When citizens submit an appeal request for a case on a self-service Web site, an activity record for the appeal request is automatically created for the case. This activity has a Type field value of Appeal Request. Agents can complete the procedure in this topic to accept or reject such an appeal request. For information about submitting an appeal request for a case on a self-service Web site, see Siebel Self Service Administration Guide if you use Siebel Public Sector Self Service.

This task is a step in Process of Managing Appeal Cases.

To accept or reject an appeal request

Navigate to the Cases screen, then the Case List view.
Drill down on the Case Name field for the case associated with the appeal request.
In the Activities list, review the reason for the appeal request in the Description field of the activity for the appeal request.
To review documentation that is associated with the appeal request, complete the following steps:
1. Navigate to the Attachments view.
  In this view, you can see all of the attachments that are associated with the case.
2. In the Attachments list, drill down on the Attachment Name field for the attachment records that appear to review documentation might be associated with the appeal request.
3. Navigate to the Activities view to go back to the Activities list.
In the Activities list, change the Status field of the activity for the appeal request as follows:
1. If you want to accept the appeal request, then change the Status field to Approved.
  If you accept the appeal request, then you must create an appeal case for the original case. For more information, see Creating Appeal Cases.
2. If you want to reject the appeal request, then change the Status field to Declined.
(Optional) Enter text in the Description field of the activity to explain the reason for accepting or rejecting the appeal request.
On a self-service Web site, the citizen who is associated with the case might have already entered text in this field. Add to, but do not delete, the citizen’s text. This citizen can view your text in the Summary field for the appeal request activity on the self-service Web site.

Creating Appeal Cases

Complete the procedure in this topic to create an appeal case. For more information, see About Appeal Cases.

When you create an appeal case for a case with a Status field value of Closed, the Status field value of the closed case changes to Active. You cannot create an appeal case for a case with a Status field value of Inactive or Submitted.

If you create an appeal case because you approve an appeal request that a citizen submits on a self-service Web site, then the Web Access field in the Contacts view of the appeal case is automatically selected so that the citizen can access the appeal case on the self-service Web site.

Note: In the preconfigured Siebel Public Sector application, the Appeal button is enabled only for cases that have a Category field of Benefit. Administrators can enable this button for additional case categories. For more information, see Configuring Case Categories for Appeal Cases.

This task is a step in Process of Managing Appeal Cases.

To create an appeal case

Navigate to the Cases screen, then the Case List view.
Select the case for which you want to create an appeal case.
Click Appeal.
The appeal case appears in the Appeal Cases view.
(Optional) If the appeal date is not the same as the current date, then complete the following steps:
1. Navigate to the Case List view, and change the current date in the Case Name field of the appeal case to the appeal date.
2. Drill down on the Case Name field of the appeal case, navigate to the Evidence view, and change the current date in the Evidence Name field of the evidence record to the appeal date.

Developing Appeal Cases

To support an appeal, a citizen can provide relevant documentation to the agent or manager who manages the appeal case. To develop an appeal case, the agent or manager includes this supporting documentation in the appeal case record. Also, a citizen can use a self-service Web site to include this supporting documentation in the original case or the appeal case.

You cannot change the status of (or delete) cases that are associated with appeal case records that are active. When you delete the case that is associated with an appeal case, the appeal case record is also deleted.

When an appeal case is created, the evidence record that is created in the Evidence view for that appeal case has a value of Document in the Evidence Type field and value of Case Snapshot in the Evidence Subtype field. You cannot delete this evidence record, but if you delete the associated appeal case, then the evidence record is automatically deleted.

When an appeal case is created, the snapshot file that is created in the Attachments view for the evidence record has a value of Case Snapshot in the Evidence Type field, and the System Generated check box is selected. You cannot delete this snapshot file, but if the associated evidence record is deleted, then the snapshot file is automatically deleted.

This task is a step in Process of Managing Appeal Cases.

To develop an appeal case

Navigate to the Cases screen, then the Case List view.
Drill down on the Case Name field of the active appeal case, and navigate to the Evidence view.
(Optional) Create a new evidence record for the appeal case, and complete the fields as appropriate.
For more information, see Creating Evidence Records.
Drill down on the Evidence Name field of an evidence record in the appeal case, and navigate to the Attachments view.
Add an attachment to the evidence record for the appeal case.
For more information, see Adding Attachments to Cases.

Completing Appeal Cases

To make a decision about an appeal, a board reviews the evidence in the appeal case and any other evidence or arguments that the citizen presents to the board. After its review, the board might decide to increase benefits (or approve the appeal), not change benefits (or deny the appeal), decrease benefits, suspend benefits, or terminate benefits.

After the board makes a decision about an appeal, the agent who manages the citizen’s case, completes the appeal case by changing the status of the appeal case to Closed. If the citizen re-appeals the case, then the agent can change the status of the appeal case back to Active, or the agent can delete the appeal case and create a new one.

This task is a step in Process of Managing Appeal Cases.

To complete an appeal case

Navigate to the Cases screen, then the Case List view.
Change the Status field of the appeal case to Closed.
(Optional) Change the Sub-Status field of the appeal case to the appropriate value.
If necessary, change the appropriate fields for citizen data relating to the case.
If necessary, reassign the benefits for the citizen’s original case:
- For more information about automatically assigning benefits to cases, see Automatically Assigning Benefits to Cases.
- For more information about manually assigning benefits to cases, see Manually Assigning Benefits to Cases.

Performing Quality Assurance Reviews

At any time during case processing or after case completion, agents can review a case for purposes of quality assurance. This review determines whether the case is processed according to agency procedures and governmental regulations.

To review a case for quality assurance, you select a quality assurance plan template that is associated with the case type for the case. This template facilitates uniformity in the case review process. After you save the quality assurance plan, the list of items that you must review appears in the Quality Assurance Items list. After you review an item, you update the item in this list.

After you select a template for a quality assurance plan, you can delete that template only if all of the template items do not have a check in the Completed field. You cannot add items to or delete items from a template that you select to create a quality assurance plan.

This task is a step in Roadmap for Managing Benefits Cases.

To perform a quality assurance review

Navigate to the Cases screen, then the Case List view.
Drill down on the Case Name field of the case for which you want to perform a quality assurance review.
The Case form appears with views that show more details about the case.

Navigate to the QA Plans view, create a new record in the QA Plans list, and complete the fields as appropriate.

The following table describes some of the fields.

Field	Description
Planned Start	Select the date and time that you plan to begin reviewing the case for quality assurance.
Template Name	Select the appropriate template to use to review the case. You must select a template to create a quality assurance plan. Only the templates that apply to the case type are available for selection. After you save the quality assurance plan and exit the case record, you cannot change the Case Type field of the case.
Name	Displays the name of the template that you select, but you can change this value to a different name.
Description	Displays the description of the template that you select.

Select Save Record in the menu that appears when you click the cogwheel icon for QA plans.
The items that are associated with the template that you select appear in the Quality Assurance Items list (which follows the QA Plans list).
After you finish the review work for an item in the Quality Assurance Items list, complete the following steps:
- In the Completed field, select the check box for the item.
  When you select another field for the item, the Date Completed field is populated with the current date and time, and the Completed By field is populated with your user name.
- (Optional) In the QA Item Type field, select a value to indicate the nature of the quality assurance review for this item.
- (Optional) In the Quality Type field, select a rating of the quality assurance review for this item.
- (Optional) Enter any remarks in the Comments field.