Scenario Overview

Today’s Veterans have a comprehensive medical benefits package, which VA administers through an annual patient enrollment system. The enrollment system is based on priority groups to ensure health care benefits are readily available to all enrolled Veterans.

This example shows how to evaluate which Medical Priority Group a Veteran would belong to using the multi-sheet Decision Table capabilities of North52's business rules engine for Microsoft Dynamics 365.

The documentation for these requirements can be found on the VA website:

To be eligible you must fit into one of the following categories:

Rule # Description
Priority Group 1
Priority Group 2
Priority Group 3
  • Veterans who are Former Prisoners of War (POWs)
  • Veterans awarded a Purple Heart medal
  • Veterans whose discharge was for a disability that was incurred or aggravated in the line of duty
  • Veterans with VA-rated service-connected disabilities 10% or 20% disabling
  • Veterans awarded special eligibility classification under Title 38, U.S.C., § 1151,
    "benefits for individuals disabled by treatment or vocational rehabilitation"
  • Veterans awarded the Medal Of Honor (MOH)
Priority Group 4
  • Veterans who are receiving aid and attendance or housebound benefits from VA
  • Veterans who have been determined by VA to be catastrophically disabled
Priority Group 5
  • Nonservice-connected Veterans and noncompensable service-connected Veterans rated 0% disabled
    by VA with annual income below the VA’s and geographically
    (based on your resident zip code) adjusted income limits
  • Veterans receiving VA pension benefits
  • Veterans eligible for Medicaid programs
Priority Group 6
  • Compensable 0% service-connected Veterans
  • Veterans exposed to Ionizing Radiation during atmospheric testing or during the
    occupation of Hiroshima and Nagasaki
  • Project 112/SHAD participants
  • Veterans who served in the Republic of Vietnam between January 9, 1962 and May 7, 1975
  • Veterans of the Persian Gulf War who served between August 2, 1990 and November 11, 1998
  • Veterans who served on active duty at Camp Lejeune for at least 30 days between August 1, 1953 and
    December 31, 1987
  • Veterans who served in a theater of combat operations after November 11, 1998 as follows:
    • Currently enrolled Veterans and new enrollees who were discharged from active duty on or
      after January 28, 2003, are eligible for the enhanced benefits for five years post discharge.
    • Combat Veterans who were discharged between January 2009 and January 2011, and did not enroll
      in the VA health care during their five-year period of eligibility have an
      additional one year to enroll and receive care.
      The additional one-year eligibility period began February 12, 2015 with the signing of
      the Clay Hunt Suicide Prevention for America Veterans Act.
Priority Group 7
Priority Group 8


North52 Decision Suite Solution

The North52 Decision Suite solution works like this:

  • A Formula of type Save - Perform Action is created on the Contact entity
  • The Source Properties are set to the fields used by the Multi-Sheet Decision Table
  • The Event is set to Create & Update
  • Exit this Decision Table on First Match is turned On on all Decision Tables
  • Exit All Decision Tables on First Match is turned On on all Decision Tables

Multi-Sheet Decision Table

Priority Group 1

Priority Group 2

Priority Group 3

Priority Group 4

Priority Group 5

 Priority Group 6

Priority Group 7 & 8  

Note: In this example the Dynamics 365 system doesn't store all the data and instead lifts it from other systems via web service calls etc. This way the Decision Table is able to execute without the need to store vast amounts of data within the Dynamics CRM system itself.

This example uses publicly available information on the owners website and has not been endorsed by the owner of the information.

Did you know?

North52 Decision Suite lets you:

North52 Decision Suite enables you to:

  • Author business rules to define automated decisions using industry-leading approaches
  • Measure and maximize decision quality using decision analytics
  • Deploy, progress and optimize decisions that drive your ongoing business operations

Learn more about the North52 Decision Suite