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SAS Business Intelligence & Reporting Module — Software Requirements Specification (SRS)

Table of Contents

1 Document Information

FieldValue
Project NameSAS Business Intelligence & Reporting Module
Version1.0
Date Created2025-10-17
Date Modified2025-10-17
Document TypeSoftware Requirements Specification
Module CodeREPORTING
Prepared BySky Software Engineering Team
StatusDraft

2 Project Overview

2.1 Description

The Business Intelligence & Reporting module provides comprehensive analytics, reporting, and data visualization capabilities across all SAS modules. It includes executive dashboards for C-level decision making, operational reports for day-to-day management, advanced analytics for claims/membership/financial/provider/wellness data, custom report builder for ad-hoc analysis, scheduled report distribution, data exports, regulatory reporting, and real-time KPI monitoring. The module integrates with all operational modules to provide unified reporting and supports multi-dimensional analysis, drill-down capabilities, data export in multiple formats, and role-based access to reports and dashboards.

2.2 Objectives

  • Provide real-time executive dashboards for strategic decision making
  • Enable operational reporting across all modules (claims, membership, finance, sales, provider, wellness)
  • Support advanced analytics with drill-down, filtering, and multi-dimensional analysis
  • Offer custom report builder for business users to create ad-hoc reports
  • Automate scheduled report generation and distribution
  • Enable data exports in multiple formats (Excel, PDF, CSV, JSON)
  • Support regulatory reporting requirements (TIRA, tax authorities)
  • Provide real-time KPI monitoring and alerts
  • Enable self-service BI for authorized users
  • Maintain audit trail for all report access and generation

2.3 Scope

2.3.1 In Scope

  • Executive dashboards (KPIs, trends, performance metrics)
  • Operational reports (claims, membership, finance, sales, provider, wellness)
  • Financial analytics (revenue, expenses, profitability, loss ratios)
  • Claims analytics (frequency, severity, patterns, fraud indicators)
  • Membership analytics (enrollment, retention, demographics, lifetime value)
  • Sales & agent performance reports
  • Utilization analysis (medical services, provider patterns)
  • Provider analytics (performance, cost efficiency, quality metrics)
  • Wellness program metrics and ROI analysis
  • Custom report builder with drag-and-drop interface
  • Scheduled reports with automated distribution
  • Data exports (Excel, PDF, CSV, JSON)
  • Regulatory reporting (TIRA, tax, statutory returns)
  • Ad-hoc querying and analysis
  • Report versioning and audit trail
  • Role-based access control for reports

2.3.2 Out Of Scope

  • External BI tool integrations (Power BI, Tableau) - covered in Infrastructure module
  • Data warehouse ETL processes - covered in Infrastructure module
  • Machine learning and predictive analytics - future enhancement
  • Real-time streaming analytics - future enhancement

2.4 Technology Stack

2.4.1 Backend

Django REST Framework, PostgreSQL, Redis (caching), Celery (scheduled reports)

2.4.2 Frontend

React 19 (web dashboards), Chart.js/D3.js (visualizations)

2.4.3 Reporting Engine

Custom report builder + PDF generation (WeasyPrint/ReportLab)

2.4.4 Data Export

openpyxl (Excel), pandas (CSV), JSON serializers

2.4.5 Database

PostgreSQL with materialized views for performance

2.5 Key Stakeholders

  • Executive Management (CEO, CFO, COO)
  • Finance Team (financial reports, revenue analysis)
  • Claims Team (claims analytics, fraud detection)
  • Underwriting Team (risk assessment, pricing analytics)
  • Sales Management (agent performance, conversion rates)
  • Provider Network Team (provider performance, utilization)
  • Wellness Team (program metrics, ROI analysis)
  • Compliance Team (regulatory reporting)
  • IT/BI Team (report administration, custom reports)

3 User Requirements

3.1 Executive Dashboards

Feature CodeI Want ToSo That I CanPriorityNotes
FT-RPT-EXEC-KPI-DASHBOARDview executive KPI dashboard with real-time metricsmonitor overall business performance at a glanceMust HaveKey metrics: total members, premium revenue, claims ratio, net profit, new policies, retention rate, average claim cost, customer satisfaction. Real-time updates, trend indicators (up/down arrows), comparison to targets.
FT-RPT-EXEC-FINANCIAL-SUMMARYview financial performance summary dashboardtrack revenue, expenses, profitability trendsMust HaveRevenue breakdown by product/region, expense analysis, profit margin trends, loss ratio by product, combined ratio, cash flow summary. Monthly/quarterly/yearly views.
FT-RPT-EXEC-CLAIMS-OVERVIEWview claims performance overview dashboardmonitor claims trends and identify issuesMust HaveClaims submitted vs settled, average TAT, claims ratio, fraud alerts, high-value claims, claims by category/provider, pending claims backlog.
FT-RPT-EXEC-MEMBERSHIP-TRENDSview membership growth and retention dashboardtrack enrollment trends and member lifecycleMust HaveTotal members by product/region, new enrollments, terminations, retention rate, churn analysis, member demographics, lifetime value trends.
FT-RPT-EXEC-DRILLDOWNdrill down from executive dashboard to detailed reportsinvestigate specific metrics and trendsMust HaveClick on any metric to drill down to underlying data, filter by date range/product/region, export drill-down results, maintain context during navigation.

3.2 Operational Reports

Feature CodeI Want ToSo That I CanPriorityNotes
FT-RPT-OPS-CLAIMS-DETAILgenerate detailed claims reportsanalyze claims by various dimensionsMust HaveFilter by date range, product, provider, claim type, status, amount range. Group by product/provider/diagnosis/member. Export to Excel/PDF/CSV.
FT-RPT-OPS-MEMBERSHIP-DETAILgenerate detailed membership reportsanalyze member demographics and statusMust HaveActive/inactive members, enrollments/terminations by period, member demographics (age, gender, location), policy details, dependent analysis.
FT-RPT-OPS-FINANCIAL-DETAILgenerate detailed financial reportsanalyze revenue, expenses, and profitabilityMust HavePremium collection reports, outstanding receivables, commission payments, provider payments, expense breakdown, profit/loss by product/region.
FT-RPT-OPS-SALES-DETAILgenerate detailed sales and agent performance reportstrack sales metrics and agent productivityMust HavePolicies sold, premium generated, conversion rates, agent rankings, commission earned, pipeline analysis, sales by product/region/channel.
FT-RPT-OPS-PROVIDER-DETAILgenerate detailed provider network reportsanalyze provider utilization and performanceMust HaveProvider directory, utilization by provider, claims frequency/severity, capitation payments, fee-for-service payments, network coverage by region.
FT-RPT-OPS-WELLNESS-DETAILgenerate detailed wellness program reportstrack wellness participation and outcomesMust HaveScreening participation, vaccination rates, challenge participation, fitness tracker activity, health risk assessment results, program ROI analysis.

3.3 Financial Analytics

Feature CodeI Want ToSo That I CanPriorityNotes
FT-RPT-FIN-REVENUE-ANALYSISanalyze premium revenue trends and compositionunderstand revenue drivers and forecast future revenueMust HaveRevenue by product/region/channel/sales agent, trend analysis (MoM, YoY), revenue forecasting, premium rate analysis, payment collection rates.
FT-RPT-FIN-LOSS-RATIOcalculate and analyze loss ratiosassess product profitability and pricing adequacyMust HaveLoss ratio by product/region/period, incurred claims vs earned premium, ultimate loss ratio projections, comparison to industry benchmarks, trend analysis.
FT-RPT-FIN-EXPENSE-ANALYSISanalyze operating expenses and cost structureidentify cost optimization opportunitiesMust HaveExpense breakdown (claims, commission, admin, IT, marketing), expense ratio by product, cost per member, cost trend analysis, budget vs actual.
FT-RPT-FIN-PROFITABILITYanalyze profitability by product, region, and segmentidentify profitable and unprofitable segmentsMust HaveProfit margin by product/region/customer segment, contribution margin analysis, break-even analysis, ROI by product, profitability trends.
FT-RPT-FIN-CASHFLOWanalyze cash flow and working capitalmanage liquidity and financial healthMust HaveCash inflows (premium collection), cash outflows (claims, commission, expenses), working capital analysis, cash flow forecasting, aging analysis of receivables/payables.

3.4 Claims Analytics

Feature CodeI Want ToSo That I CanPriorityNotes
FT-RPT-CLM-FREQUENCY-SEVERITYanalyze claims frequency and severityunderstand claims patterns and trendsMust HaveClaims frequency (count per 1000 members), average claim severity (amount per claim), frequency-severity distribution, trends by product/region/period.
FT-RPT-CLM-CATEGORY-ANALYSISanalyze claims by category and diagnosisidentify high-cost conditions and utilization patternsMust HaveClaims by category (inpatient, outpatient, pharmacy, dental, optical), top diagnoses by frequency/cost, chronic condition prevalence, preventable condition analysis.
FT-RPT-CLM-PROVIDER-ANALYSISanalyze claims by provideridentify high-cost providers and utilization patternsMust HaveClaims volume by provider, average cost per claim by provider, provider cost efficiency comparison, outlier detection, network vs non-network utilization.
FT-RPT-CLM-FRAUD-INDICATORSidentify potential fraud patterns in claims dataflag suspicious claims for investigationMust HaveDuplicate claims detection, unusual billing patterns, high-frequency claimants, provider fraud indicators, member fraud patterns, fraud alert dashboard.
FT-RPT-CLM-TAT-ANALYSISanalyze claims processing turnaround timemonitor and improve claims processing efficiencyMust HaveAverage TAT by claim type/complexity, TAT distribution, SLA compliance rate, bottleneck identification, adjudicator performance, trend analysis.

3.5 Membership Analytics

Feature CodeI Want ToSo That I CanPriorityNotes
FT-RPT-MBR-ENROLLMENT-TRENDSanalyze member enrollment and termination trendsunderstand member lifecycle and growth patternsMust HaveNew enrollments by period/product/channel, terminations by reason, net growth, seasonality analysis, enrollment funnel conversion rates.
FT-RPT-MBR-RETENTION-ANALYSISanalyze member retention and churnidentify retention drivers and reduce churnMust HaveRetention rate by product/cohort/period, churn rate analysis, termination reason breakdown, member tenure distribution, retention by sales channel/agent.
FT-RPT-MBR-DEMOGRAPHICSanalyze member demographics and segmentationunderstand member composition and target segmentsMust HaveAge/gender distribution, geographic distribution, product mix, family size, employer group analysis, corporate vs individual members.
FT-RPT-MBR-LIFETIME-VALUEcalculate and analyze member lifetime valueprioritize high-value member segmentsMust HaveLTV calculation by segment/cohort, contribution margin per member, acquisition cost vs LTV, LTV trends over time, predictive LTV modeling.
FT-RPT-MBR-UTILIZATIONanalyze member utilization patternsunderstand healthcare consumption behaviorMust HaveUtilization rate (members with claims vs total), high utilizers identification, utilization by age/gender/product, preventive care utilization, wellness program participation.

3.6 Sales Analytics

Feature CodeI Want ToSo That I CanPriorityNotes
FT-RPT-SLS-AGENT-PERFORMANCEanalyze sales agent performancetrack productivity and identify top performersMust HavePolicies sold per agent, premium generated, conversion rate, average policy value, agent rankings, commission earned, retention rate of sold policies.
FT-RPT-SLS-CHANNEL-ANALYSISanalyze sales by channeloptimize channel strategy and resource allocationMust HaveSales by channel (direct, broker, corporate, online), channel conversion rates, cost per acquisition by channel, channel profitability, channel growth trends.
FT-RPT-SLS-PRODUCT-MIXanalyze sales product mixunderstand product demand and optimize portfolioMust HavePolicies sold by product, premium generated by product, product growth trends, cross-sell/up-sell analysis, product profitability.
FT-RPT-SLS-PIPELINEanalyze sales pipeline and conversion funnelforecast sales and identify conversion bottlenecksMust HaveLead pipeline by stage, conversion rates by stage, average time in each stage, win/loss analysis, forecasted sales, pipeline velocity.

3.7 Utilization Analytics

Feature CodeI Want ToSo That I CanPriorityNotes
FT-RPT-UTL-SERVICE-UTILIZATIONanalyze utilization of medical servicesunderstand healthcare consumption patternsMust HaveUtilization by service type (inpatient, outpatient, pharmacy, etc.), utilization rate per 1000 members, high utilizers, seasonal patterns, regional variations.
FT-RPT-UTL-PROVIDER-PATTERNSanalyze provider utilization patternsoptimize provider network and contractsMust HaveMost utilized providers, provider market share, network vs non-network utilization, provider concentration, geographic coverage gaps.
FT-RPT-UTL-COST-EFFICIENCYanalyze cost efficiency of utilizationidentify cost optimization opportunitiesMust HaveCost per service type, cost per member per month, cost variation by provider/region, preventable costs, generic vs brand drug utilization.

3.8 Provider Analytics

Feature CodeI Want ToSo That I CanPriorityNotes
FT-RPT-PRV-PERFORMANCEanalyze provider performance metricsidentify high-performing and underperforming providersMust HaveProvider quality scores, claims approval rate, average cost per visit, member satisfaction, readmission rates, adherence to protocols.
FT-RPT-PRV-COST-ANALYSISanalyze provider costs and efficiencynegotiate contracts and optimize networkMust HaveCost per provider vs network average, fee schedule compliance, outlier identification, capitation vs fee-for-service cost comparison.
FT-RPT-PRV-NETWORK-COVERAGEanalyze provider network coverageidentify gaps and expansion opportunitiesMust HaveProvider density by region/specialty, member-to-provider ratio, geographic coverage maps, network adequacy assessment, specialty coverage gaps.

3.9 Wellness Analytics

Feature CodeI Want ToSo That I CanPriorityNotes
FT-RPT-WELL-PARTICIPATIONanalyze wellness program participationmeasure engagement and identify improvement areasMust HaveParticipation rate by program, demographic breakdown, repeat participation, engagement trends, barriers to participation analysis.
FT-RPT-WELL-OUTCOMESanalyze wellness program health outcomesmeasure program effectivenessMust HaveBiometric improvements, risk score changes, chronic disease management outcomes, preventive care utilization, lifestyle behavior changes.
FT-RPT-WELL-ROIcalculate wellness program ROIjustify investment in wellness programsMust HaveProgram costs vs savings (reduced claims), cost per participant, healthcare cost trend for participants vs non-participants, productivity gains, engagement ROI.

3.10 Custom Report Builder

Feature CodeI Want ToSo That I CanPriorityNotes
FT-RPT-CUSTOM-BUILDERbuild custom reports using drag-and-drop interfacecreate ad-hoc reports without IT assistanceMust HaveDrag-and-drop fields, filters, grouping, sorting. Available data sources: claims, members, policies, providers, payments, wellness. Preview before generating.
FT-RPT-CUSTOM-SAVE-SHAREsave and share custom reportsreuse reports and collaborate with teamMust HaveSave report definition, name and categorize, share with users/roles, version history, clone and modify existing reports.
FT-RPT-CUSTOM-VISUALIZATIONSadd visualizations to custom reportspresent data in charts and graphsMust HaveChart types: bar, line, pie, scatter, heatmap. Customize colors, labels, legends. Multiple visualizations per report, export charts as images.
FT-RPT-CUSTOM-CALCULATIONSadd calculated fields to custom reportsperform custom analyticsMust HaveFormula builder with functions (sum, avg, count, percentage, ratios), aggregations (group by), conditional calculations, date calculations.

3.11 Scheduled Reports

Feature CodeI Want ToSo That I CanPriorityNotes
FT-RPT-SCHEDULE-CONFIGschedule reports for automated generationreceive regular reports without manual effortMust HaveSchedule frequency: daily, weekly, monthly, quarterly, annual. Time of day, day of week/month. Effective date range, expiration.
FT-RPT-SCHEDULE-DISTRIBUTIONconfigure automated report distributiondeliver reports to stakeholders automaticallyMust HaveEmail distribution list, attachment format (PDF, Excel), report portal notification, FTP/SFTP delivery option, distribution log.
FT-RPT-SCHEDULE-HISTORYview history of scheduled report executionstrack delivery and troubleshoot issuesMust HaveExecution log (success/failure), generated report archive, download previous reports, error details, retry failed reports.

3.12 Data Exports

Feature CodeI Want ToSo That I CanPriorityNotes
FT-RPT-EXPORT-EXCELexport reports to Excel formatperform additional analysis in spreadsheetsMust HaveMulti-sheet workbooks, formatted cells, formulas, charts, preserve styling, large dataset support (100K+ rows).
FT-RPT-EXPORT-PDFexport reports to PDF formatshare professional formatted reportsMust HaveProfessional layout, company branding, page headers/footers, table of contents, charts and visualizations, print-ready format.
FT-RPT-EXPORT-CSVexport reports to CSV formatimport data into other systemsMust HaveConfigurable delimiter, UTF-8 encoding, header row option, large file support, streaming export for big datasets.
FT-RPT-EXPORT-JSONexport reports to JSON formatintegrate with APIs and applicationsMust HaveStructured JSON schema, nested objects support, metadata included, pagination for large datasets, API endpoint for exports.

3.13 Regulatory Reporting

Feature CodeI Want ToSo That I CanPriorityNotes
FT-RPT-REG-TIRA-RETURNSgenerate TIRA statutory returnscomply with regulatory requirementsMust HaveTIRA quarterly/annual returns, prescribed format, data validation, audit trail, electronic submission format, archival.
FT-RPT-REG-TAX-RETURNSgenerate tax returns and supporting documentscomply with tax obligationsMust HaveVAT returns, income tax supporting schedules, withholding tax reports, prescribed format, validation, archival.
FT-RPT-REG-STATUTORY-ACCOUNTSgenerate statutory financial statementsmeet regulatory and governance requirementsMust HaveBalance sheet, income statement, cash flow statement, notes to accounts, IFRS 17 compliant, trial balance, audit trail.
FT-RPT-REG-COMPLIANCEgenerate compliance monitoring reportsdemonstrate regulatory complianceMust HaveSolvency margin calculations, investment compliance, governance compliance, complaint registers, required disclosures.

3.14 Adhoc Querying

Feature CodeI Want ToSo That I CanPriorityNotes
FT-RPT-ADHOC-QUERY-BUILDERbuild ad-hoc queries using query builderanswer specific business questions quicklyMust HaveVisual query builder, filter conditions (AND/OR), sorting, aggregations, limit results, save queries for reuse.
FT-RPT-ADHOC-QUICK-FILTERSapply quick filters to existing reportsslice data by different dimensionsMust HaveCommon filters: date range, product, region, provider, status. Filter persistence, clear all filters, filter presets.
FT-RPT-ADHOC-DATA-PREVIEWpreview data before generating full reportverify query results and save timeMust HaveSample data preview (first 100 rows), record count, performance estimation, modify query before full execution.

3.15 Report Management

Feature CodeI Want ToSo That I CanPriorityNotes
FT-RPT-MGMT-CATALOGbrowse report catalog organized by categoryfind available reports easilyMust HaveCategories: executive, operational, financial, claims, membership, sales, provider, wellness, regulatory. Search by name/description, favorites, recently used.
FT-RPT-MGMT-ACCESS-CONTROLcontrol access to reports based on rolesensure data security and privacyMust HaveRole-based access (executive, manager, analyst, viewer), report permissions (view, edit, share, export), data-level security (filter by user's region/department).
FT-RPT-MGMT-AUDIT-TRAILmaintain audit trail of report access and generationtrack usage and ensure complianceMust HaveLog who accessed which report, when, parameters used, export actions, modifications to report definitions, retention period 7 years.
FT-RPT-MGMT-VERSIONINGmanage report versionstrack changes and rollback if neededMust HaveVersion history for report definitions, compare versions, rollback to previous version, change notes, archive old versions.

4 Detailed Feature Requirements

4.1 Ft Rpt Exec Kpi Dashboard

4.1.1 Priority

Must Have

4.1.2 User Story

As a CEO, I want to view executive KPI dashboard with real-time metrics so that I can monitor overall business performance at a glance

4.1.3 Preconditions

User authenticated with executive role, data populated in database

4.1.4 Postconditions

KPI dashboard displayed with real-time metrics, trend indicators, and comparison to targets

4.1.5 Test Cases

IdDescriptionWeight
EXEC-KPI-DASHBOARD-TC-001Verify all key metrics displayed (members, revenue, claims ratio, profit, new policies, retention, avg claim cost, CSAT)High
EXEC-KPI-DASHBOARD-TC-002Verify real-time data updatesHigh
EXEC-KPI-DASHBOARD-TC-003Verify trend indicators (up/down arrows, % change)High
EXEC-KPI-DASHBOARD-TC-004Verify comparison to targets/benchmarksHigh
EXEC-KPI-DASHBOARD-TC-005Verify date range selection (MTD, QTD, YTD)Medium
EXEC-KPI-DASHBOARD-TC-006Verify dashboard loads within 3 secondsHigh

4.2 Ft Rpt Exec Financial Summary

4.2.1 Priority

Must Have

4.2.2 User Story

As a CFO, I want to view financial performance summary dashboard so that I can track revenue, expenses, profitability trends

4.2.3 Preconditions

Financial data available, user has CFO/finance role

4.2.4 Postconditions

Financial summary dashboard displayed with revenue, expenses, profit trends, loss ratio, combined ratio

4.2.5 Test Cases

IdDescriptionWeight
EXEC-FINANCIAL-SUMMARY-TC-001Verify revenue breakdown by product/regionHigh
EXEC-FINANCIAL-SUMMARY-TC-002Verify expense analysis with categorizationHigh
EXEC-FINANCIAL-SUMMARY-TC-003Verify profit margin trends over timeHigh
EXEC-FINANCIAL-SUMMARY-TC-004Verify loss ratio calculation by productHigh
EXEC-FINANCIAL-SUMMARY-TC-005Verify combined ratio calculationHigh
EXEC-FINANCIAL-SUMMARY-TC-006Verify cash flow summaryHigh
EXEC-FINANCIAL-SUMMARY-TC-007Verify monthly/quarterly/yearly view toggleMedium

4.3 Ft Rpt Exec Claims Overview

4.3.1 Priority

Must Have

4.3.2 User Story

As a COO, I want to view claims performance overview dashboard so that I can monitor claims trends and identify issues

4.3.3 Preconditions

Claims data available, user has executive role

4.3.4 Postconditions

Claims overview dashboard displayed with key metrics, trends, and alerts

4.3.5 Test Cases

IdDescriptionWeight
EXEC-CLAIMS-OVERVIEW-TC-001Verify claims submitted vs settled countHigh
EXEC-CLAIMS-OVERVIEW-TC-002Verify average TAT calculationHigh
EXEC-CLAIMS-OVERVIEW-TC-003Verify claims ratio displayHigh
EXEC-CLAIMS-OVERVIEW-TC-004Verify fraud alerts visibleHigh
EXEC-CLAIMS-OVERVIEW-TC-005Verify high-value claims flaggedHigh
EXEC-CLAIMS-OVERVIEW-TC-006Verify claims by category breakdownMedium
EXEC-CLAIMS-OVERVIEW-TC-007Verify pending claims backlog shownHigh

4.4.1 Priority

Must Have

4.4.2 User Story

As an executive, I want to view membership growth and retention dashboard so that I can track enrollment trends and member lifecycle

4.4.3 Preconditions

Membership data available, user authenticated

4.4.4 Postconditions

Membership trends dashboard displayed with growth, retention, churn metrics

4.4.5 Test Cases

IdDescriptionWeight
EXEC-MEMBERSHIP-TRENDS-TC-001Verify total members by product/regionHigh
EXEC-MEMBERSHIP-TRENDS-TC-002Verify new enrollments over timeHigh
EXEC-MEMBERSHIP-TRENDS-TC-003Verify terminations analysisHigh
EXEC-MEMBERSHIP-TRENDS-TC-004Verify retention rate calculationHigh
EXEC-MEMBERSHIP-TRENDS-TC-005Verify churn analysis with reasonsHigh
EXEC-MEMBERSHIP-TRENDS-TC-006Verify member demographics breakdownMedium
EXEC-MEMBERSHIP-TRENDS-TC-007Verify lifetime value trendsMedium

4.5 Ft Rpt Exec Drilldown

4.5.1 Priority

Must Have

4.5.2 User Story

As an executive, I want to drill down from executive dashboard to detailed reports so that I can investigate specific metrics and trends

4.5.3 Preconditions

Executive dashboard displayed, metrics have underlying detail data

4.5.4 Postconditions

Detailed report displayed with context preserved, filters applied

4.5.5 Test Cases

IdDescriptionWeight
EXEC-DRILLDOWN-TC-001Verify click on metric opens detailed reportHigh
EXEC-DRILLDOWN-TC-002Verify filters carried forward to detail viewHigh
EXEC-DRILLDOWN-TC-003Verify breadcrumb navigation availableMedium
EXEC-DRILLDOWN-TC-004Verify export option available in drill-downMedium
EXEC-DRILLDOWN-TC-005Verify back navigation returns to dashboardMedium
EXEC-DRILLDOWN-TC-006Verify context maintained across drill levelsHigh

4.6 Ft Rpt Ops Claims Detail

4.6.1 Priority

Must Have

4.6.2 User Story

As a claims manager, I want to generate detailed claims reports so that I can analyze claims by various dimensions

4.6.3 Preconditions

Claims data available, user has claims role

4.6.4 Postconditions

Detailed claims report generated with filters, grouping, and export options

4.6.5 Test Cases

IdDescriptionWeight
OPS-CLAIMS-DETAIL-TC-001Verify filter by date range worksHigh
OPS-CLAIMS-DETAIL-TC-002Verify filter by product/provider/type/status/amountHigh
OPS-CLAIMS-DETAIL-TC-003Verify group by product/provider/diagnosis/memberHigh
OPS-CLAIMS-DETAIL-TC-004Verify export to Excel formatHigh
OPS-CLAIMS-DETAIL-TC-005Verify export to PDF formatHigh
OPS-CLAIMS-DETAIL-TC-006Verify export to CSV formatHigh
OPS-CLAIMS-DETAIL-TC-007Verify pagination for large result setsMedium

4.7 Ft Rpt Ops Membership Detail

4.7.1 Priority

Must Have

4.7.2 User Story

As a membership manager, I want to generate detailed membership reports so that I can analyze member demographics and status

4.7.3 Preconditions

Membership data available, user authenticated

4.7.4 Postconditions

Membership detail report generated with comprehensive member information

4.7.5 Test Cases

IdDescriptionWeight
OPS-MEMBERSHIP-DETAIL-TC-001Verify active/inactive member filteringHigh
OPS-MEMBERSHIP-DETAIL-TC-002Verify enrollments/terminations by periodHigh
OPS-MEMBERSHIP-DETAIL-TC-003Verify demographics breakdown (age, gender, location)High
OPS-MEMBERSHIP-DETAIL-TC-004Verify policy details includedHigh
OPS-MEMBERSHIP-DETAIL-TC-005Verify dependent analysisMedium
OPS-MEMBERSHIP-DETAIL-TC-006Verify export functionalityHigh

4.8 Ft Rpt Ops Financial Detail

4.8.1 Priority

Must Have

4.8.2 User Story

As a finance manager, I want to generate detailed financial reports so that I can analyze revenue, expenses, and profitability

4.8.3 Preconditions

Financial data available, user has finance role

4.8.4 Postconditions

Financial detail report generated with comprehensive financial data

4.8.5 Test Cases

IdDescriptionWeight
OPS-FINANCIAL-DETAIL-TC-001Verify premium collection reportHigh
OPS-FINANCIAL-DETAIL-TC-002Verify outstanding receivables reportHigh
OPS-FINANCIAL-DETAIL-TC-003Verify commission payments reportHigh
OPS-FINANCIAL-DETAIL-TC-004Verify provider payments reportHigh
OPS-FINANCIAL-DETAIL-TC-005Verify expense breakdown reportHigh
OPS-FINANCIAL-DETAIL-TC-006Verify profit/loss by product/regionHigh
OPS-FINANCIAL-DETAIL-TC-007Verify multi-currency supportHigh

4.9 Ft Rpt Ops Sales Detail

4.9.1 Priority

Must Have

4.9.2 User Story

As a sales manager, I want to generate detailed sales and agent performance reports so that I can track sales metrics and agent productivity

4.9.3 Preconditions

Sales data available, user has sales role

4.9.4 Postconditions

Sales detail report generated with agent performance metrics

4.9.5 Test Cases

IdDescriptionWeight
OPS-SALES-DETAIL-TC-001Verify policies sold by periodHigh
OPS-SALES-DETAIL-TC-002Verify premium generated reportHigh
OPS-SALES-DETAIL-TC-003Verify conversion rates calculationHigh
OPS-SALES-DETAIL-TC-004Verify agent rankings displayHigh
OPS-SALES-DETAIL-TC-005Verify commission earned reportHigh
OPS-SALES-DETAIL-TC-006Verify pipeline analysisMedium
OPS-SALES-DETAIL-TC-007Verify sales by product/region/channelHigh

4.10 Ft Rpt Ops Provider Detail

4.10.1 Priority

Must Have

4.10.2 User Story

As a provider network manager, I want to generate detailed provider network reports so that I can analyze provider utilization and performance

4.10.3 Preconditions

Provider data available, user has provider network role

4.10.4 Postconditions

Provider detail report generated with utilization and performance metrics

4.10.5 Test Cases

IdDescriptionWeight
OPS-PROVIDER-DETAIL-TC-001Verify provider directory listingHigh
OPS-PROVIDER-DETAIL-TC-002Verify utilization by providerHigh
OPS-PROVIDER-DETAIL-TC-003Verify claims frequency/severity by providerHigh
OPS-PROVIDER-DETAIL-TC-004Verify capitation payments reportHigh
OPS-PROVIDER-DETAIL-TC-005Verify fee-for-service payments reportHigh
OPS-PROVIDER-DETAIL-TC-006Verify network coverage by regionMedium

4.11 Ft Rpt Ops Wellness Detail

4.11.1 Priority

Must Have

4.11.2 User Story

As a wellness manager, I want to generate detailed wellness program reports so that I can track wellness participation and outcomes

4.11.3 Preconditions

Wellness data available, user has wellness role

4.11.4 Postconditions

Wellness detail report generated with participation and outcomes metrics

4.11.5 Test Cases

IdDescriptionWeight
OPS-WELLNESS-DETAIL-TC-001Verify screening participation ratesHigh
OPS-WELLNESS-DETAIL-TC-002Verify vaccination rates reportHigh
OPS-WELLNESS-DETAIL-TC-003Verify challenge participation metricsHigh
OPS-WELLNESS-DETAIL-TC-004Verify fitness tracker activity statsMedium
OPS-WELLNESS-DETAIL-TC-005Verify HRA results summaryHigh
OPS-WELLNESS-DETAIL-TC-006Verify wellness program ROI analysisHigh

4.12 Ft Rpt Fin Revenue Analysis

4.12.1 Priority

Must Have

4.12.2 User Story

As a CFO, I want to analyze premium revenue trends and composition so that I can understand revenue drivers and forecast future revenue

4.12.3 Preconditions

Revenue data available, user has finance role

4.12.4 Postconditions

Revenue analysis report generated with trends, composition, and forecasts

4.12.5 Test Cases

IdDescriptionWeight
FIN-REVENUE-ANALYSIS-TC-001Verify revenue by product breakdownHigh
FIN-REVENUE-ANALYSIS-TC-002Verify revenue by region/channel/agentHigh
FIN-REVENUE-ANALYSIS-TC-003Verify trend analysis (MoM, YoY)High
FIN-REVENUE-ANALYSIS-TC-004Verify revenue forecasting capabilityMedium
FIN-REVENUE-ANALYSIS-TC-005Verify premium rate analysisMedium
FIN-REVENUE-ANALYSIS-TC-006Verify payment collection ratesHigh

4.13 Ft Rpt Fin Loss Ratio

4.13.1 Priority

Must Have

4.13.2 User Story

As an actuary, I want to calculate and analyze loss ratios so that I can assess product profitability and pricing adequacy

4.13.3 Preconditions

Claims and premium data available, user has finance/actuarial role

4.13.4 Postconditions

Loss ratio analysis report generated with calculations by product, region, period

4.13.5 Test Cases

IdDescriptionWeight
FIN-LOSS-RATIO-TC-001Verify loss ratio calculation formula (incurred claims / earned premium)High
FIN-LOSS-RATIO-TC-002Verify loss ratio by productHigh
FIN-LOSS-RATIO-TC-003Verify loss ratio by region/periodHigh
FIN-LOSS-RATIO-TC-004Verify incurred vs earned premium calculationHigh
FIN-LOSS-RATIO-TC-005Verify ultimate loss ratio projectionsMedium
FIN-LOSS-RATIO-TC-006Verify comparison to industry benchmarksMedium
FIN-LOSS-RATIO-TC-007Verify trend analysis over timeHigh

4.14 Ft Rpt Fin Expense Analysis

4.14.1 Priority

Must Have

4.14.2 User Story

As a CFO, I want to analyze operating expenses and cost structure so that I can identify cost optimization opportunities

4.14.3 Preconditions

Expense data available, user has finance role

4.14.4 Postconditions

Expense analysis report generated with breakdown, ratios, trends

4.14.5 Test Cases

IdDescriptionWeight
FIN-EXPENSE-ANALYSIS-TC-001Verify expense breakdown by category (claims, commission, admin, IT, marketing)High
FIN-EXPENSE-ANALYSIS-TC-002Verify expense ratio by product calculationHigh
FIN-EXPENSE-ANALYSIS-TC-003Verify cost per member calculationHigh
FIN-EXPENSE-ANALYSIS-TC-004Verify cost trend analysisHigh
FIN-EXPENSE-ANALYSIS-TC-005Verify budget vs actual comparisonHigh
FIN-EXPENSE-ANALYSIS-TC-006Verify variance analysis with explanationsMedium

4.15 Ft Rpt Fin Profitability

4.15.1 Priority

Must Have

4.15.2 User Story

As a CFO, I want to analyze profitability by product, region, and segment so that I can identify profitable and unprofitable segments

4.15.3 Preconditions

Financial data available across all dimensions, user has finance role

4.15.4 Postconditions

Profitability analysis report generated with multi-dimensional breakdown

4.15.5 Test Cases

IdDescriptionWeight
FIN-PROFITABILITY-TC-001Verify profit margin by product calculationHigh
FIN-PROFITABILITY-TC-002Verify profitability by regionHigh
FIN-PROFITABILITY-TC-003Verify profitability by customer segmentHigh
FIN-PROFITABILITY-TC-004Verify contribution margin analysisHigh
FIN-PROFITABILITY-TC-005Verify break-even analysisMedium
FIN-PROFITABILITY-TC-006Verify ROI by product calculationHigh
FIN-PROFITABILITY-TC-007Verify profitability trends over timeHigh

4.16 Ft Rpt Fin Cashflow

4.16.1 Priority

Must Have

4.16.2 User Story

As a CFO, I want to analyze cash flow and working capital so that I can manage liquidity and financial health

4.16.3 Preconditions

Cash flow data available, user has finance role

4.16.4 Postconditions

Cash flow analysis report generated with inflows, outflows, forecasts

4.16.5 Test Cases

IdDescriptionWeight
FIN-CASHFLOW-TC-001Verify cash inflows (premium collection) trackingHigh
FIN-CASHFLOW-TC-002Verify cash outflows (claims, commission, expenses) trackingHigh
FIN-CASHFLOW-TC-003Verify working capital analysisHigh
FIN-CASHFLOW-TC-004Verify cash flow forecastingMedium
FIN-CASHFLOW-TC-005Verify aging analysis of receivablesHigh
FIN-CASHFLOW-TC-006Verify aging analysis of payablesHigh

4.17 Ft Rpt Clm Frequency Severity

4.17.1 Priority

Must Have

4.17.2 User Story

As an actuarial analyst, I want to analyze claims frequency and severity so that I can understand claims patterns and trends

4.17.3 Preconditions

Claims data available with member counts, user has claims/actuarial role

4.17.4 Postconditions

Frequency-severity analysis report generated with distributions and trends

4.17.5 Test Cases

IdDescriptionWeight
CLM-FREQUENCY-SEVERITY-TC-001Verify claims frequency calculation (count per 1000 members)High
CLM-FREQUENCY-SEVERITY-TC-002Verify average claim severity calculation (amount per claim)High
CLM-FREQUENCY-SEVERITY-TC-003Verify frequency-severity distribution chartHigh
CLM-FREQUENCY-SEVERITY-TC-004Verify trends by product analysisHigh
CLM-FREQUENCY-SEVERITY-TC-005Verify trends by region analysisHigh
CLM-FREQUENCY-SEVERITY-TC-006Verify trends by period (MoM, YoY)High

4.18 Ft Rpt Clm Category Analysis

4.18.1 Priority

Must Have

4.18.2 User Story

As a claims manager, I want to analyze claims by category and diagnosis so that I can identify high-cost conditions and utilization patterns

4.18.3 Preconditions

Claims data with categories and diagnoses, user has claims role

4.18.4 Postconditions

Category analysis report generated with cost drivers and patterns

4.18.5 Test Cases

IdDescriptionWeight
CLM-CATEGORY-ANALYSIS-TC-001Verify claims by category (inpatient, outpatient, pharmacy, dental, optical)High
CLM-CATEGORY-ANALYSIS-TC-002Verify top diagnoses by frequencyHigh
CLM-CATEGORY-ANALYSIS-TC-003Verify top diagnoses by costHigh
CLM-CATEGORY-ANALYSIS-TC-004Verify chronic condition prevalenceHigh
CLM-CATEGORY-ANALYSIS-TC-005Verify preventable condition analysisMedium
CLM-CATEGORY-ANALYSIS-TC-006Verify cost per category calculationHigh

4.19 Ft Rpt Clm Provider Analysis

4.19.1 Priority

Must Have

4.19.2 User Story

As a provider network manager, I want to analyze claims by provider so that I can identify high-cost providers and utilization patterns

4.19.3 Preconditions

Claims data with provider information, user has provider network role

4.19.4 Postconditions

Provider analysis report generated with cost and utilization metrics

4.19.5 Test Cases

IdDescriptionWeight
CLM-PROVIDER-ANALYSIS-TC-001Verify claims volume by providerHigh
CLM-PROVIDER-ANALYSIS-TC-002Verify average cost per claim by providerHigh
CLM-PROVIDER-ANALYSIS-TC-003Verify provider cost efficiency comparisonHigh
CLM-PROVIDER-ANALYSIS-TC-004Verify outlier detection (unusually high costs)High
CLM-PROVIDER-ANALYSIS-TC-005Verify network vs non-network utilizationHigh
CLM-PROVIDER-ANALYSIS-TC-006Verify provider ranking by cost/volumeMedium

4.20 Ft Rpt Clm Fraud Indicators

4.20.1 Priority

Must Have

4.20.2 User Story

As a fraud investigator, I want to identify potential fraud patterns in claims data so that I can flag suspicious claims for investigation

4.20.3 Preconditions

Claims data available, fraud detection rules configured, user has fraud investigation role

4.20.4 Postconditions

Fraud indicators report generated with flagged claims and patterns

4.20.5 Test Cases

IdDescriptionWeight
CLM-FRAUD-INDICATORS-TC-001Verify duplicate claims detectionHigh
CLM-FRAUD-INDICATORS-TC-002Verify unusual billing patterns flaggedHigh
CLM-FRAUD-INDICATORS-TC-003Verify high-frequency claimants identifiedHigh
CLM-FRAUD-INDICATORS-TC-004Verify provider fraud indicators trackedHigh
CLM-FRAUD-INDICATORS-TC-005Verify member fraud patterns identifiedHigh
CLM-FRAUD-INDICATORS-TC-006Verify fraud alert dashboard availableHigh
CLM-FRAUD-INDICATORS-TC-007Verify flagged claims can be exported for investigationMedium

4.21 Ft Rpt Clm Tat Analysis

4.21.1 Priority

Must Have

4.21.2 User Story

As a claims manager, I want to analyze claims processing turnaround time so that I can monitor and improve claims processing efficiency

4.21.3 Preconditions

Claims data with timestamps, SLA targets configured, user has claims role

4.21.4 Postconditions

TAT analysis report generated with efficiency metrics and bottlenecks

4.21.5 Test Cases

IdDescriptionWeight
CLM-TAT-ANALYSIS-TC-001Verify average TAT by claim typeHigh
CLM-TAT-ANALYSIS-TC-002Verify average TAT by complexityHigh
CLM-TAT-ANALYSIS-TC-003Verify TAT distribution (histogram)Medium
CLM-TAT-ANALYSIS-TC-004Verify SLA compliance rate calculationHigh
CLM-TAT-ANALYSIS-TC-005Verify bottleneck identificationHigh
CLM-TAT-ANALYSIS-TC-006Verify adjudicator performance comparisonHigh
CLM-TAT-ANALYSIS-TC-007Verify trend analysis over timeHigh

4.22.1 Priority

Must Have

4.22.2 User Story

As a membership manager, I want to analyze member enrollment and termination trends so that I can understand member lifecycle and growth patterns

4.22.3 Preconditions

Membership data available, user has membership role

4.22.4 Postconditions

Enrollment trends report generated with growth metrics and patterns

4.22.5 Test Cases

IdDescriptionWeight
MBR-ENROLLMENT-TRENDS-TC-001Verify new enrollments by periodHigh
MBR-ENROLLMENT-TRENDS-TC-002Verify enrollments by product analysisHigh
MBR-ENROLLMENT-TRENDS-TC-003Verify enrollments by channel (direct, broker, corporate)High
MBR-ENROLLMENT-TRENDS-TC-004Verify terminations by reason breakdownHigh
MBR-ENROLLMENT-TRENDS-TC-005Verify net growth calculationHigh
MBR-ENROLLMENT-TRENDS-TC-006Verify seasonality analysisMedium
MBR-ENROLLMENT-TRENDS-TC-007Verify enrollment funnel conversion ratesHigh

4.23 Ft Rpt Mbr Retention Analysis

4.23.1 Priority

Must Have

4.23.2 User Story

As a marketing manager, I want to analyze member retention and churn so that I can identify retention drivers and reduce churn

4.23.3 Preconditions

Membership data with enrollment/termination dates, user has membership/marketing role

4.23.4 Postconditions

Retention analysis report generated with retention rate, churn rate, and drivers

4.23.5 Test Cases

IdDescriptionWeight
MBR-RETENTION-ANALYSIS-TC-001Verify retention rate by product calculationHigh
MBR-RETENTION-ANALYSIS-TC-002Verify retention by cohort analysisHigh
MBR-RETENTION-ANALYSIS-TC-003Verify retention by period (monthly, annual)High
MBR-RETENTION-ANALYSIS-TC-004Verify churn rate analysisHigh
MBR-RETENTION-ANALYSIS-TC-005Verify termination reason breakdownHigh
MBR-RETENTION-ANALYSIS-TC-006Verify member tenure distributionMedium
MBR-RETENTION-ANALYSIS-TC-007Verify retention by sales channel/agentHigh

4.24 Ft Rpt Mbr Demographics

4.24.1 Priority

Must Have

4.24.2 User Story

As a marketing manager, I want to analyze member demographics and segmentation so that I can understand member composition and target segments

4.24.3 Preconditions

Member demographic data available, user has membership/marketing role

4.24.4 Postconditions

Demographics report generated with breakdowns by age, gender, location, product, etc.

4.24.5 Test Cases

IdDescriptionWeight
MBR-DEMOGRAPHICS-TC-001Verify age distribution analysisHigh
MBR-DEMOGRAPHICS-TC-002Verify gender distribution analysisHigh
MBR-DEMOGRAPHICS-TC-003Verify geographic distributionHigh
MBR-DEMOGRAPHICS-TC-004Verify product mix analysisHigh
MBR-DEMOGRAPHICS-TC-005Verify family size distributionMedium
MBR-DEMOGRAPHICS-TC-006Verify employer group analysisHigh
MBR-DEMOGRAPHICS-TC-007Verify corporate vs individual member breakdownHigh

4.25 Ft Rpt Mbr Lifetime Value

4.25.1 Priority

Must Have

4.25.2 User Story

As a marketing manager, I want to calculate and analyze member lifetime value so that I can prioritize high-value member segments

4.25.3 Preconditions

Member revenue and cost data available, user has marketing/finance role

4.25.4 Postconditions

LTV analysis report generated with calculations by segment and cohort

4.25.5 Test Cases

IdDescriptionWeight
MBR-LIFETIME-VALUE-TC-001Verify LTV calculation by segmentHigh
MBR-LIFETIME-VALUE-TC-002Verify LTV by cohort analysisHigh
MBR-LIFETIME-VALUE-TC-003Verify contribution margin per member calculationHigh
MBR-LIFETIME-VALUE-TC-004Verify acquisition cost vs LTV comparisonHigh
MBR-LIFETIME-VALUE-TC-005Verify LTV trends over timeHigh
MBR-LIFETIME-VALUE-TC-006Verify predictive LTV modeling availableMedium

4.26 Ft Rpt Mbr Utilization

4.26.1 Priority

Must Have

4.26.2 User Story

As a claims manager, I want to analyze member utilization patterns so that I can understand healthcare consumption behavior

4.26.3 Preconditions

Member and claims data available, user has claims/membership role

4.26.4 Postconditions

Member utilization report generated with utilization metrics and patterns

4.26.5 Test Cases

IdDescriptionWeight
MBR-UTILIZATION-TC-001Verify utilization rate (members with claims vs total)High
MBR-UTILIZATION-TC-002Verify high utilizers identificationHigh
MBR-UTILIZATION-TC-003Verify utilization by age groupHigh
MBR-UTILIZATION-TC-004Verify utilization by genderHigh
MBR-UTILIZATION-TC-005Verify utilization by productHigh
MBR-UTILIZATION-TC-006Verify preventive care utilization trackingHigh
MBR-UTILIZATION-TC-007Verify wellness program participation correlationMedium

4.27 Ft Rpt Sls Agent Performance

4.27.1 Priority

Must Have

4.27.2 User Story

As a sales manager, I want to analyze sales agent performance so that I can track productivity and identify top performers

4.27.3 Preconditions

Sales data available, user has sales management role

4.27.4 Postconditions

Agent performance report generated with rankings and metrics

4.27.5 Test Cases

IdDescriptionWeight
SLS-AGENT-PERFORMANCE-TC-001Verify policies sold per agentHigh
SLS-AGENT-PERFORMANCE-TC-002Verify premium generated per agentHigh
SLS-AGENT-PERFORMANCE-TC-003Verify conversion rate by agentHigh
SLS-AGENT-PERFORMANCE-TC-004Verify average policy value by agentHigh
SLS-AGENT-PERFORMANCE-TC-005Verify agent rankingsHigh
SLS-AGENT-PERFORMANCE-TC-006Verify commission earned by agentHigh
SLS-AGENT-PERFORMANCE-TC-007Verify retention rate of sold policiesHigh

4.28 Ft Rpt Sls Channel Analysis

4.28.1 Priority

Must Have

4.28.2 User Story

As a sales manager, I want to analyze sales by channel so that I can optimize channel strategy and resource allocation

4.28.3 Preconditions

Sales data with channel information, user has sales management role

4.28.4 Postconditions

Channel analysis report generated with performance by channel

4.28.5 Test Cases

IdDescriptionWeight
SLS-CHANNEL-ANALYSIS-TC-001Verify sales by channel (direct, broker, corporate, online)High
SLS-CHANNEL-ANALYSIS-TC-002Verify channel conversion ratesHigh
SLS-CHANNEL-ANALYSIS-TC-003Verify cost per acquisition by channelHigh
SLS-CHANNEL-ANALYSIS-TC-004Verify channel profitability analysisHigh
SLS-CHANNEL-ANALYSIS-TC-005Verify channel growth trendsHigh
SLS-CHANNEL-ANALYSIS-TC-006Verify channel market shareMedium

4.29 Ft Rpt Sls Product Mix

4.29.1 Priority

Must Have

4.29.2 User Story

As a product manager, I want to analyze sales product mix so that I can understand product demand and optimize portfolio

4.29.3 Preconditions

Sales data by product, user has product/sales management role

4.29.4 Postconditions

Product mix analysis report generated with demand patterns

4.29.5 Test Cases

IdDescriptionWeight
SLS-PRODUCT-MIX-TC-001Verify policies sold by productHigh
SLS-PRODUCT-MIX-TC-002Verify premium generated by productHigh
SLS-PRODUCT-MIX-TC-003Verify product growth trendsHigh
SLS-PRODUCT-MIX-TC-004Verify cross-sell analysisHigh
SLS-PRODUCT-MIX-TC-005Verify up-sell analysisHigh
SLS-PRODUCT-MIX-TC-006Verify product profitability correlationHigh

4.30 Ft Rpt Sls Pipeline

4.30.1 Priority

Must Have

4.30.2 User Story

As a sales manager, I want to analyze sales pipeline and conversion funnel so that I can forecast sales and identify conversion bottlenecks

4.30.3 Preconditions

Pipeline data available, user has sales management role

4.30.4 Postconditions

Pipeline analysis report generated with forecasts and conversion metrics

4.30.5 Test Cases

IdDescriptionWeight
SLS-PIPELINE-TC-001Verify lead pipeline by stageHigh
SLS-PIPELINE-TC-002Verify conversion rates by stageHigh
SLS-PIPELINE-TC-003Verify average time in each stageHigh
SLS-PIPELINE-TC-004Verify win/loss analysisHigh
SLS-PIPELINE-TC-005Verify forecasted sales calculationHigh
SLS-PIPELINE-TC-006Verify pipeline velocity metricsMedium

4.31 Ft Rpt Utl Service Utilization

4.31.1 Priority

Must Have

4.31.2 User Story

As a utilization manager, I want to analyze utilization of medical services so that I can understand healthcare consumption patterns

4.31.3 Preconditions

Claims data with service types, member counts, user has utilization management role

4.31.4 Postconditions

Service utilization report generated with patterns and rates

4.31.5 Test Cases

IdDescriptionWeight
UTL-SERVICE-UTILIZATION-TC-001Verify utilization by service type (inpatient, outpatient, pharmacy, etc.)High
UTL-SERVICE-UTILIZATION-TC-002Verify utilization rate per 1000 membersHigh
UTL-SERVICE-UTILIZATION-TC-003Verify high utilizers identificationHigh
UTL-SERVICE-UTILIZATION-TC-004Verify seasonal patterns analysisMedium
UTL-SERVICE-UTILIZATION-TC-005Verify regional variationsHigh
UTL-SERVICE-UTILIZATION-TC-006Verify trend analysis over timeHigh

4.32 Ft Rpt Utl Provider Patterns

4.32.1 Priority

Must Have

4.32.2 User Story

As a provider network manager, I want to analyze provider utilization patterns so that I can optimize provider network and contracts

4.32.3 Preconditions

Claims data with provider information, user has provider network role

4.32.4 Postconditions

Provider utilization report generated with patterns and concentration metrics

4.32.5 Test Cases

IdDescriptionWeight
UTL-PROVIDER-PATTERNS-TC-001Verify most utilized providers identificationHigh
UTL-PROVIDER-PATTERNS-TC-002Verify provider market share calculationHigh
UTL-PROVIDER-PATTERNS-TC-003Verify network vs non-network utilizationHigh
UTL-PROVIDER-PATTERNS-TC-004Verify provider concentration analysisHigh
UTL-PROVIDER-PATTERNS-TC-005Verify geographic coverage gaps identificationHigh
UTL-PROVIDER-PATTERNS-TC-006Verify specialty utilization patternsMedium

4.33 Ft Rpt Utl Cost Efficiency

4.33.1 Priority

Must Have

4.33.2 User Story

As a finance manager, I want to analyze cost efficiency of utilization so that I can identify cost optimization opportunities

4.33.3 Preconditions

Claims cost data, user has finance/utilization management role

4.33.4 Postconditions

Cost efficiency report generated with opportunities for optimization

4.33.5 Test Cases

IdDescriptionWeight
UTL-COST-EFFICIENCY-TC-001Verify cost per service type calculationHigh
UTL-COST-EFFICIENCY-TC-002Verify cost per member per month (PMPM)High
UTL-COST-EFFICIENCY-TC-003Verify cost variation by providerHigh
UTL-COST-EFFICIENCY-TC-004Verify cost variation by regionHigh
UTL-COST-EFFICIENCY-TC-005Verify preventable costs identificationHigh
UTL-COST-EFFICIENCY-TC-006Verify generic vs brand drug utilization cost impactHigh

4.34 Ft Rpt Prv Performance

4.34.1 Priority

Must Have

4.34.2 User Story

As a provider network manager, I want to analyze provider performance metrics so that I can identify high-performing and underperforming providers

4.34.3 Preconditions

Provider performance data available, user has provider network role

4.34.4 Postconditions

Provider performance report generated with quality and efficiency metrics

4.34.5 Test Cases

IdDescriptionWeight
PRV-PERFORMANCE-TC-001Verify provider quality scores displayHigh
PRV-PERFORMANCE-TC-002Verify claims approval rate by providerHigh
PRV-PERFORMANCE-TC-003Verify average cost per visit by providerHigh
PRV-PERFORMANCE-TC-004Verify member satisfaction scoresHigh
PRV-PERFORMANCE-TC-005Verify readmission rates trackingMedium
PRV-PERFORMANCE-TC-006Verify adherence to protocols assessmentMedium

4.35 Ft Rpt Prv Cost Analysis

4.35.1 Priority

Must Have

4.35.2 User Story

As a provider network manager, I want to analyze provider costs and efficiency so that I can negotiate contracts and optimize network

4.35.3 Preconditions

Provider cost data available, user has provider network role

4.35.4 Postconditions

Provider cost analysis report generated with efficiency benchmarks

4.35.5 Test Cases

IdDescriptionWeight
PRV-COST-ANALYSIS-TC-001Verify cost per provider vs network averageHigh
PRV-COST-ANALYSIS-TC-002Verify fee schedule compliance trackingHigh
PRV-COST-ANALYSIS-TC-003Verify outlier identification (high-cost providers)High
PRV-COST-ANALYSIS-TC-004Verify capitation vs fee-for-service cost comparisonHigh
PRV-COST-ANALYSIS-TC-005Verify cost trend by provider over timeHigh
PRV-COST-ANALYSIS-TC-006Verify cost efficiency rankingHigh

4.36 Ft Rpt Prv Network Coverage

4.36.1 Priority

Must Have

4.36.2 User Story

As a provider network manager, I want to analyze provider network coverage so that I can identify gaps and expansion opportunities

4.36.3 Preconditions

Provider location data, member location data, user has provider network role

4.36.4 Postconditions

Network coverage report generated with gap analysis and recommendations

4.36.5 Test Cases

IdDescriptionWeight
PRV-NETWORK-COVERAGE-TC-001Verify provider density by regionHigh
PRV-NETWORK-COVERAGE-TC-002Verify provider density by specialtyHigh
PRV-NETWORK-COVERAGE-TC-003Verify member-to-provider ratio calculationHigh
PRV-NETWORK-COVERAGE-TC-004Verify geographic coverage maps displayedHigh
PRV-NETWORK-COVERAGE-TC-005Verify network adequacy assessmentHigh
PRV-NETWORK-COVERAGE-TC-006Verify specialty coverage gaps identificationHigh

4.37 Ft Rpt Well Participation

4.37.1 Priority

Must Have

4.37.2 User Story

As a wellness manager, I want to analyze wellness program participation so that I can measure engagement and identify improvement areas

4.37.3 Preconditions

Wellness participation data available, user has wellness role

4.37.4 Postconditions

Wellness participation report generated with engagement metrics and barriers

4.37.5 Test Cases

IdDescriptionWeight
WELL-PARTICIPATION-TC-001Verify participation rate by programHigh
WELL-PARTICIPATION-TC-002Verify demographic breakdown of participantsHigh
WELL-PARTICIPATION-TC-003Verify repeat participation trackingHigh
WELL-PARTICIPATION-TC-004Verify engagement trends over timeHigh
WELL-PARTICIPATION-TC-005Verify barriers to participation analysisMedium
WELL-PARTICIPATION-TC-006Verify participation vs non-participation comparisonHigh

4.38 Ft Rpt Well Outcomes

4.38.1 Priority

Must Have

4.38.2 User Story

As a wellness manager, I want to analyze wellness program health outcomes so that I can measure program effectiveness

4.38.3 Preconditions

Wellness outcomes data available, user has wellness role

4.38.4 Postconditions

Wellness outcomes report generated with health improvements and effectiveness metrics

4.38.5 Test Cases

IdDescriptionWeight
WELL-OUTCOMES-TC-001Verify biometric improvements tracking (weight, BP, cholesterol, etc.)High
WELL-OUTCOMES-TC-002Verify risk score changes analysisHigh
WELL-OUTCOMES-TC-003Verify chronic disease management outcomesHigh
WELL-OUTCOMES-TC-004Verify preventive care utilization increaseHigh
WELL-OUTCOMES-TC-005Verify lifestyle behavior changes trackingMedium
WELL-OUTCOMES-TC-006Verify before/after comparison for participantsHigh

4.39 Ft Rpt Well Roi

4.39.1 Priority

Must Have

4.39.2 User Story

As a wellness manager, I want to calculate wellness program ROI so that I can justify investment in wellness programs

4.39.3 Preconditions

Wellness program costs and claims data available, user has wellness/finance role

4.39.4 Postconditions

Wellness ROI report generated with cost-benefit analysis

4.39.5 Test Cases

IdDescriptionWeight
WELL-ROI-TC-001Verify program costs calculationHigh
WELL-ROI-TC-002Verify savings calculation (reduced claims)High
WELL-ROI-TC-003Verify cost per participant calculationHigh
WELL-ROI-TC-004Verify healthcare cost trend comparison (participants vs non-participants)High
WELL-ROI-TC-005Verify productivity gains estimationMedium
WELL-ROI-TC-006Verify engagement ROI calculationMedium
WELL-ROI-TC-007Verify ROI trend over timeHigh

4.40 Ft Rpt Custom Builder

4.40.1 Priority

Must Have

4.40.2 User Story

As a business analyst, I want to build custom reports using drag-and-drop interface so that I can create ad-hoc reports without IT assistance

4.40.3 Preconditions

User authenticated with report builder access, data sources configured

4.40.4 Postconditions

Custom report built and executed successfully

4.40.5 Test Cases

IdDescriptionWeight
CUSTOM-BUILDER-TC-001Verify drag-and-drop fields to report canvasHigh
CUSTOM-BUILDER-TC-002Verify filter configuration (conditions, operators)High
CUSTOM-BUILDER-TC-003Verify grouping configurationHigh
CUSTOM-BUILDER-TC-004Verify sorting configurationHigh
CUSTOM-BUILDER-TC-005Verify data sources available (claims, members, policies, providers, payments, wellness)High
CUSTOM-BUILDER-TC-006Verify preview before generating full reportHigh
CUSTOM-BUILDER-TC-007Verify report execution and displayHigh

4.41 Ft Rpt Custom Save Share

4.41.1 Priority

Must Have

4.41.2 User Story

As a business analyst, I want to save and share custom reports so that I can reuse reports and collaborate with team

4.41.3 Preconditions

Custom report created, user authenticated

4.41.4 Postconditions

Report saved and shared with specified users/roles

4.41.5 Test Cases

IdDescriptionWeight
CUSTOM-SAVE-SHARE-TC-001Verify save report definitionHigh
CUSTOM-SAVE-SHARE-TC-002Verify name and categorize reportHigh
CUSTOM-SAVE-SHARE-TC-003Verify share with users/rolesHigh
CUSTOM-SAVE-SHARE-TC-004Verify version history trackingMedium
CUSTOM-SAVE-SHARE-TC-005Verify clone and modify existing reportsHigh
CUSTOM-SAVE-SHARE-TC-006Verify access control on shared reportsHigh

4.42 Ft Rpt Custom Visualizations

4.42.1 Priority

Must Have

4.42.2 User Story

As a business analyst, I want to add visualizations to custom reports so that I can present data in charts and graphs

4.42.3 Preconditions

Custom report with data, user authenticated

4.42.4 Postconditions

Visualizations added to report and displayed correctly

4.42.5 Test Cases

IdDescriptionWeight
CUSTOM-VISUALIZATIONS-TC-001Verify chart types available (bar, line, pie, scatter, heatmap)High
CUSTOM-VISUALIZATIONS-TC-002Verify customize colorsMedium
CUSTOM-VISUALIZATIONS-TC-003Verify customize labels and legendsMedium
CUSTOM-VISUALIZATIONS-TC-004Verify multiple visualizations per reportHigh
CUSTOM-VISUALIZATIONS-TC-005Verify export charts as imagesMedium
CUSTOM-VISUALIZATIONS-TC-006Verify chart data linked to report dataHigh

4.43 Ft Rpt Custom Calculations

4.43.1 Priority

Must Have

4.43.2 User Story

As a business analyst, I want to add calculated fields to custom reports so that I can perform custom analytics

4.43.3 Preconditions

Custom report builder open, user authenticated

4.43.4 Postconditions

Calculated fields added to report and computed correctly

4.43.5 Test Cases

IdDescriptionWeight
CUSTOM-CALCULATIONS-TC-001Verify formula builder with functions (sum, avg, count, percentage, ratios)High
CUSTOM-CALCULATIONS-TC-002Verify aggregations (group by) supportHigh
CUSTOM-CALCULATIONS-TC-003Verify conditional calculations (IF/THEN)High
CUSTOM-CALCULATIONS-TC-004Verify date calculations (date diff, date add, etc.)High
CUSTOM-CALCULATIONS-TC-005Verify calculation validation and error handlingHigh
CUSTOM-CALCULATIONS-TC-006Verify calculated field naming and reuseMedium

4.44 Ft Rpt Schedule Config

4.44.1 Priority

Must Have

4.44.2 User Story

As a report administrator, I want to schedule reports for automated generation so that I can receive regular reports without manual effort

4.44.3 Preconditions

Report defined, user has scheduling permissions

4.44.4 Postconditions

Report schedule configured and activated

4.44.5 Test Cases

IdDescriptionWeight
SCHEDULE-CONFIG-TC-001Verify schedule frequency options (daily, weekly, monthly, quarterly, annual)High
SCHEDULE-CONFIG-TC-002Verify time of day configurationHigh
SCHEDULE-CONFIG-TC-003Verify day of week/month configurationHigh
SCHEDULE-CONFIG-TC-004Verify effective date range configurationMedium
SCHEDULE-CONFIG-TC-005Verify expiration date configurationMedium
SCHEDULE-CONFIG-TC-006Verify schedule activation/deactivationHigh

4.45 Ft Rpt Schedule Distribution

4.45.1 Priority

Must Have

4.45.2 User Story

As a report administrator, I want to configure automated report distribution so that I can deliver reports to stakeholders automatically

4.45.3 Preconditions

Report scheduled, user has distribution permissions

4.45.4 Postconditions

Distribution configured and reports delivered automatically

4.45.5 Test Cases

IdDescriptionWeight
SCHEDULE-DISTRIBUTION-TC-001Verify email distribution list configurationHigh
SCHEDULE-DISTRIBUTION-TC-002Verify attachment format selection (PDF, Excel)High
SCHEDULE-DISTRIBUTION-TC-003Verify report portal notification optionMedium
SCHEDULE-DISTRIBUTION-TC-004Verify FTP/SFTP delivery optionMedium
SCHEDULE-DISTRIBUTION-TC-005Verify distribution log maintainedHigh
SCHEDULE-DISTRIBUTION-TC-006Verify email delivery with proper formattingHigh

4.46 Ft Rpt Schedule History

4.46.1 Priority

Must Have

4.46.2 User Story

As a report administrator, I want to view history of scheduled report executions so that I can track delivery and troubleshoot issues

4.46.3 Preconditions

Scheduled reports exist, user has admin access

4.46.4 Postconditions

Execution history displayed with status and details

4.46.5 Test Cases

IdDescriptionWeight
SCHEDULE-HISTORY-TC-001Verify execution log shows success/failureHigh
SCHEDULE-HISTORY-TC-002Verify generated report archive accessibleHigh
SCHEDULE-HISTORY-TC-003Verify download previous reportsHigh
SCHEDULE-HISTORY-TC-004Verify error details available for failed executionsHigh
SCHEDULE-HISTORY-TC-005Verify retry failed reports capabilityMedium
SCHEDULE-HISTORY-TC-006Verify execution time and duration trackedMedium

4.47 Ft Rpt Export Excel

4.47.1 Priority

Must Have

4.47.2 User Story

As a business user, I want to export reports to Excel format so that I can perform additional analysis in spreadsheets

4.47.3 Preconditions

Report generated, user authenticated

4.47.4 Postconditions

Report exported to Excel file successfully

4.47.5 Test Cases

IdDescriptionWeight
EXPORT-EXCEL-TC-001Verify multi-sheet workbooks supportedHigh
EXPORT-EXCEL-TC-002Verify formatted cells preservedMedium
EXPORT-EXCEL-TC-003Verify formulas included where applicableMedium
EXPORT-EXCEL-TC-004Verify charts included in exportMedium
EXPORT-EXCEL-TC-005Verify styling preserved (colors, fonts, borders)Medium
EXPORT-EXCEL-TC-006Verify large dataset support (100K+ rows)High
EXPORT-EXCEL-TC-007Verify file download successfulHigh

4.48 Ft Rpt Export Pdf

4.48.1 Priority

Must Have

4.48.2 User Story

As a business user, I want to export reports to PDF format so that I can share professional formatted reports

4.48.3 Preconditions

Report generated, user authenticated

4.48.4 Postconditions

Report exported to PDF file successfully

4.48.5 Test Cases

IdDescriptionWeight
EXPORT-PDF-TC-001Verify professional layout appliedHigh
EXPORT-PDF-TC-002Verify company branding includedMedium
EXPORT-PDF-TC-003Verify page headers/footers presentMedium
EXPORT-PDF-TC-004Verify table of contents for multi-section reportsMedium
EXPORT-PDF-TC-005Verify charts and visualizations rendered correctlyHigh
EXPORT-PDF-TC-006Verify print-ready formatMedium
EXPORT-PDF-TC-007Verify file download successfulHigh

4.49 Ft Rpt Export Csv

4.49.1 Priority

Must Have

4.49.2 User Story

As a data analyst, I want to export reports to CSV format so that I can import data into other systems

4.49.3 Preconditions

Report generated, user authenticated

4.49.4 Postconditions

Report exported to CSV file successfully

4.49.5 Test Cases

IdDescriptionWeight
EXPORT-CSV-TC-001Verify configurable delimiter (comma, semicolon, tab)Medium
EXPORT-CSV-TC-002Verify UTF-8 encodingHigh
EXPORT-CSV-TC-003Verify header row optionHigh
EXPORT-CSV-TC-004Verify large file supportHigh
EXPORT-CSV-TC-005Verify streaming export for big datasetsHigh
EXPORT-CSV-TC-006Verify file download successfulHigh

4.50 Ft Rpt Export Json

4.50.1 Priority

Must Have

4.50.2 User Story

As a developer, I want to export reports to JSON format so that I can integrate with APIs and applications

4.50.3 Preconditions

Report generated, user has API access

4.50.4 Postconditions

Report exported to JSON format successfully

4.50.5 Test Cases

IdDescriptionWeight
EXPORT-JSON-TC-001Verify structured JSON schemaHigh
EXPORT-JSON-TC-002Verify nested objects supportHigh
EXPORT-JSON-TC-003Verify metadata included (report name, date, parameters)Medium
EXPORT-JSON-TC-004Verify pagination for large datasetsHigh
EXPORT-JSON-TC-005Verify API endpoint for exports availableHigh
EXPORT-JSON-TC-006Verify JSON validation and proper formattingHigh

4.51 Ft Rpt Reg Tira Returns

4.51.1 Priority

Must Have

4.51.2 User Story

As a compliance officer, I want to generate TIRA statutory returns so that I can comply with regulatory requirements

4.51.3 Preconditions

Financial and operational data available, user has compliance role

4.51.4 Postconditions

TIRA returns generated in prescribed format

4.51.5 Test Cases

IdDescriptionWeight
REG-TIRA-RETURNS-TC-001Verify TIRA quarterly returns generationHigh
REG-TIRA-RETURNS-TC-002Verify TIRA annual returns generationHigh
REG-TIRA-RETURNS-TC-003Verify prescribed format complianceHigh
REG-TIRA-RETURNS-TC-004Verify data validation before submissionHigh
REG-TIRA-RETURNS-TC-005Verify audit trail maintainedHigh
REG-TIRA-RETURNS-TC-006Verify electronic submission formatHigh
REG-TIRA-RETURNS-TC-007Verify archival of submitted returnsMedium

4.52 Ft Rpt Reg Tax Returns

4.52.1 Priority

Must Have

4.52.2 User Story

As a tax officer, I want to generate tax returns and supporting documents so that I can comply with tax obligations

4.52.3 Preconditions

Financial data available, user has tax/finance role

4.52.4 Postconditions

Tax returns generated in prescribed format

4.52.5 Test Cases

IdDescriptionWeight
REG-TAX-RETURNS-TC-001Verify VAT returns generationHigh
REG-TAX-RETURNS-TC-002Verify income tax supporting schedulesHigh
REG-TAX-RETURNS-TC-003Verify withholding tax reportsHigh
REG-TAX-RETURNS-TC-004Verify prescribed format complianceHigh
REG-TAX-RETURNS-TC-005Verify validation before submissionHigh
REG-TAX-RETURNS-TC-006Verify archival of tax returnsMedium

4.53 Ft Rpt Reg Statutory Accounts

4.53.1 Priority

Must Have

4.53.2 User Story

As a CFO, I want to generate statutory financial statements so that I can meet regulatory and governance requirements

4.53.3 Preconditions

Financial data available, user has CFO/finance role

4.53.4 Postconditions

Statutory accounts generated in compliance with IFRS 17

4.53.5 Test Cases

IdDescriptionWeight
REG-STATUTORY-ACCOUNTS-TC-001Verify balance sheet generationHigh
REG-STATUTORY-ACCOUNTS-TC-002Verify income statement generationHigh
REG-STATUTORY-ACCOUNTS-TC-003Verify cash flow statement generationHigh
REG-STATUTORY-ACCOUNTS-TC-004Verify notes to accountsHigh
REG-STATUTORY-ACCOUNTS-TC-005Verify IFRS 17 complianceHigh
REG-STATUTORY-ACCOUNTS-TC-006Verify trial balance supportHigh
REG-STATUTORY-ACCOUNTS-TC-007Verify audit trail maintainedHigh

4.54 Ft Rpt Reg Compliance

4.54.1 Priority

Must Have

4.54.2 User Story

As a compliance officer, I want to generate compliance monitoring reports so that I can demonstrate regulatory compliance

4.54.3 Preconditions

Compliance data available, user has compliance role

4.54.4 Postconditions

Compliance reports generated with monitoring metrics

4.54.5 Test Cases

IdDescriptionWeight
REG-COMPLIANCE-TC-001Verify solvency margin calculationsHigh
REG-COMPLIANCE-TC-002Verify investment compliance reportsHigh
REG-COMPLIANCE-TC-003Verify governance compliance reportsHigh
REG-COMPLIANCE-TC-004Verify complaint registers generationHigh
REG-COMPLIANCE-TC-005Verify required disclosures includedHigh
REG-COMPLIANCE-TC-006Verify compliance tracking over timeMedium

4.55 Ft Rpt Adhoc Query Builder

4.55.1 Priority

Must Have

4.55.2 User Story

As a business analyst, I want to build ad-hoc queries using query builder so that I can answer specific business questions quickly

4.55.3 Preconditions

User authenticated with query builder access

4.55.4 Postconditions

Ad-hoc query executed and results displayed

4.55.5 Test Cases

IdDescriptionWeight
ADHOC-QUERY-BUILDER-TC-001Verify visual query builder interfaceHigh
ADHOC-QUERY-BUILDER-TC-002Verify filter conditions (AND/OR logic)High
ADHOC-QUERY-BUILDER-TC-003Verify sorting configurationHigh
ADHOC-QUERY-BUILDER-TC-004Verify aggregations supportHigh
ADHOC-QUERY-BUILDER-TC-005Verify limit results optionMedium
ADHOC-QUERY-BUILDER-TC-006Verify save queries for reuseHigh

4.56 Ft Rpt Adhoc Quick Filters

4.56.1 Priority

Must Have

4.56.2 User Story

As a report user, I want to apply quick filters to existing reports so that I can slice data by different dimensions

4.56.3 Preconditions

Report displayed, user authenticated

4.56.4 Postconditions

Quick filters applied and report updated

4.56.5 Test Cases

IdDescriptionWeight
ADHOC-QUICK-FILTERS-TC-001Verify common filters available (date range, product, region, provider, status)High
ADHOC-QUICK-FILTERS-TC-002Verify filter persistence across page refreshMedium
ADHOC-QUICK-FILTERS-TC-003Verify clear all filters optionHigh
ADHOC-QUICK-FILTERS-TC-004Verify filter presets for common scenariosMedium
ADHOC-QUICK-FILTERS-TC-005Verify multiple filters can be applied simultaneouslyHigh
ADHOC-QUICK-FILTERS-TC-006Verify report updates dynamically on filter changeHigh

4.57 Ft Rpt Adhoc Data Preview

4.57.1 Priority

Must Have

4.57.2 User Story

As a business analyst, I want to preview data before generating full report so that I can verify query results and save time

4.57.3 Preconditions

Query or report configured, user authenticated

4.57.4 Postconditions

Data preview displayed with sample results

4.57.5 Test Cases

IdDescriptionWeight
ADHOC-DATA-PREVIEW-TC-001Verify sample data preview (first 100 rows)High
ADHOC-DATA-PREVIEW-TC-002Verify record count displayedHigh
ADHOC-DATA-PREVIEW-TC-003Verify performance estimation shownMedium
ADHOC-DATA-PREVIEW-TC-004Verify modify query before full executionHigh
ADHOC-DATA-PREVIEW-TC-005Verify preview loads quickly (< 2 seconds)High
ADHOC-DATA-PREVIEW-TC-006Verify proceed to full report generationHigh

4.58 Ft Rpt Mgmt Catalog

4.58.1 Priority

Must Have

4.58.2 User Story

As a report user, I want to browse report catalog organized by category so that I can find available reports easily

4.58.3 Preconditions

User authenticated, reports exist in catalog

4.58.4 Postconditions

Report catalog displayed with categorization and search

4.58.5 Test Cases

IdDescriptionWeight
MGMT-CATALOG-TC-001Verify categories displayed (executive, operational, financial, claims, membership, sales, provider, wellness, regulatory)High
MGMT-CATALOG-TC-002Verify search by name/descriptionHigh
MGMT-CATALOG-TC-003Verify favorites functionalityMedium
MGMT-CATALOG-TC-004Verify recently used reports shownMedium
MGMT-CATALOG-TC-005Verify report preview/description availableMedium
MGMT-CATALOG-TC-006Verify access to authorized reports onlyHigh

4.59 Ft Rpt Mgmt Access Control

4.59.1 Priority

Must Have

4.59.2 User Story

As a report administrator, I want to control access to reports based on roles so that I can ensure data security and privacy

4.59.3 Preconditions

Reports defined, roles configured, user has admin access

4.59.4 Postconditions

Access control configured and enforced

4.59.5 Test Cases

IdDescriptionWeight
MGMT-ACCESS-CONTROL-TC-001Verify role-based access (executive, manager, analyst, viewer)High
MGMT-ACCESS-CONTROL-TC-002Verify report permissions (view, edit, share, export)High
MGMT-ACCESS-CONTROL-TC-003Verify data-level security (filter by user's region/department)High
MGMT-ACCESS-CONTROL-TC-004Verify unauthorized access blockedHigh
MGMT-ACCESS-CONTROL-TC-005Verify permission inheritance from rolesHigh
MGMT-ACCESS-CONTROL-TC-006Verify override permissions for specific usersMedium

4.60 Ft Rpt Mgmt Audit Trail

4.60.1 Priority

Must Have

4.60.2 User Story

As a compliance officer, I want to maintain audit trail of report access and generation so that I can track usage and ensure compliance

4.60.3 Preconditions

Reports accessed/generated, user has compliance role

4.60.4 Postconditions

Audit trail maintained with comprehensive logging

4.60.5 Test Cases

IdDescriptionWeight
MGMT-AUDIT-TRAIL-TC-001Verify log who accessed which reportHigh
MGMT-AUDIT-TRAIL-TC-002Verify log when report accessedHigh
MGMT-AUDIT-TRAIL-TC-003Verify log parameters used for report generationHigh
MGMT-AUDIT-TRAIL-TC-004Verify log export actionsHigh
MGMT-AUDIT-TRAIL-TC-005Verify log modifications to report definitionsHigh
MGMT-AUDIT-TRAIL-TC-006Verify retention period 7 yearsHigh
MGMT-AUDIT-TRAIL-TC-007Verify audit log cannot be modified or deletedHigh

4.61 Ft Rpt Mgmt Versioning

4.61.1 Priority

Must Have

4.61.2 User Story

As a report administrator, I want to manage report versions so that I can track changes and rollback if needed

4.61.3 Preconditions

Reports exist, user has admin access

4.61.4 Postconditions

Report versioning enabled with history and rollback

4.61.5 Test Cases

IdDescriptionWeight
MGMT-VERSIONING-TC-001Verify version history for report definitionsHigh
MGMT-VERSIONING-TC-002Verify compare versions functionalityMedium
MGMT-VERSIONING-TC-003Verify rollback to previous versionHigh
MGMT-VERSIONING-TC-004Verify change notes captured for each versionMedium
MGMT-VERSIONING-TC-005Verify archive old versionsMedium
MGMT-VERSIONING-TC-006Verify version metadata (who, when, what changed)High