Determination takes information gathered in the Cúram system as part of intake, and applies it against enterprise-specific and program-specific rules to create eligibility decisions. Determination is different for each program. It requires a ruleset that has been defined to evaluate a participant's eligibility for benefit from a particular product.
Determination is a full eligibility test. It requires a full set of business rules and the set of data on which these rules operate. The outcome of running these business rules is that the client has either been submitted for eligibility testing or failed during the submittal process.
At minimum, the following information is needed for determination.