Enrollment Span Status Logic
Algorithm | Status | |
|---|---|---|
| 1 | Effectuation Date == NULL
AND
[(“Enrollment Span End Date” Greater than “Enrollment Span Start Date”) OR
(“Enrollment Span One Day Span Indicator = TRUE”)]
AND
Delinquency Indicator is FALSE | PRE MEMBER |
| 2 | Effectuation Date != NULL
AND
[(“Enrollment Span End Date” Greater than “Enrollment Span Start Date”) OR
(“Enrollment Span One Day Span Indicator = TRUE”)]
AND
Delinquency Indicator is FALSE | ENROLLED |
| 3 | (“Enrollment Span End Date” Less than “Enrollment Span Start Date”) | CANCELED |
| 4 | DELINQUENT | |
| 5 | SUSPENDED |