The organization can set up a custom appeals process for the applications, products and issues that it provides. Both the number of appeal levels and the type of appeal that can be created at each level are configurable on an application by application, product by product and issue case by issue case basis.
Appeal processes can be defined for products, issue cases and application integrated cases. Organizations can administratively specify for each of these case types if it is 'appealable' or not. An appeal process cannot be configured for any application/product/issue case if it has been set as 'not appealable'. For example, an overpayment is maintained administratively as a product but it may not be appropriate to allow customers to appeal an overpayment. Rather, the benefit/program from which the overpayment was created would be appealed. This is because the client is appealing the decision made on the benefit/program which resulted in the overpayment.
To allow for the escalation of an appeal to a higher decision making body, each appeal process consists of one or more levels or stages. An appeal type is specified for each stage of appeal. There are three types of appeal that can be assigned to an appeal stage: hearing case, hearing review, or judicial review. When an appeal stage has a specific type of appeal case assigned to it, only appeal cases of that type can be created for that stage of appeal. For example, if the organization assigns a hearing review to be the first stage of appeal, a user will only be able to create a hearing review appeal when creating an appeal for the product for the first time.
Alternatively, the organization has the option of allowing any type of appeal to be held at an appeal stage. This means that a hearing case, hearing review, or judicial review can be created at that stage of appeal.
The status of an appeals process is either active or canceled. An active status indicates that the appeals process is effective. An appeals process becomes effective on the start date that is specified when the appeal process is created. A canceled status indicates that the appeals process has been deleted from the system.
An appeals process can be set to become effective on a date in the future. When this date is reached, the old appeals process is treated as expired and the future appeals process becomes active on the system.