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Health Care Insurance Claim Application Test Cases

Based on the Health Care Insurance Claim Application Data Model, you can create following test cases. 

As a System Administrator, the user

  • can create a new hospital information 
  • can update an existing hospital information
  • can delete an existing hospital information
  • can create a new insurance company information
  • can update an existing insurance company information
  • can setup a new insurance claim processor staff
  • can update an insurance claim processor staff information
  • can delete a staff
  • can assign a claim to staff for processing

 As a Claim Processor Staff, the user

  • can update claim status
  • can request more information about the claim

As a Patient, the user

  • can setup patient profile online
  • can submit health care claims online
  • can request claim documentations
  • can upload requested documentations to the claim
  • can submit dispute to the claim resolution status

 As a Insurance Company admin, the user

  • the user can update company information
  • the user can update insurance coverage policies
  • the user can update insurance staff role in the system
  • the user can assign staff to insurance categories

Back End Database Verification

  • When a new hospital is added on the UI, the hospital table should have hospital_id, hospital_name and other hospital related information
  • When a patient uploads claim related receipts for treatment, the database table should contain file information
  • When a claim is processed, the database table should contain claim_id, claim_status, and other claim related information
  • When a new staff is added to the system on the UI, the database table should have staff_id, staff_name, staff_birthday, and other staff information. 
  • When an existing staff is deleted,  the database table should have the staff information deactivated.