Team Feedback — WHEN/THEN/Example Framework
Overview
Feedback to the platform team must be implementable without a single clarifying question: explicit condition + explicit behavior + evidence.
Core principle: write the condition as the error you SEE, never the cause you assume. "If MCO fails" forces eng to investigate what an MCO is; "el check automático da failed" does not.
When to Use
- New platform rules (eligibility, insurance, copay behavior)
- Bug reports
- Feature requests
- NOT for: strategy discussions, prose emails, customer-facing messages
The Output Contract
The message consists of, in order:
- One template block per rule (below)
- Optionally, ONE line starting with
Nota: flagging a concern for eng to consider
Nothing else. No intro paragraphs, no root-cause analysis, no recommendations to "investigate first" — the rule as observed is the deliverable; a concern is one Nota: line.
WHEN (condición):
Insurance = [Trading Partner ID] ([nombre])
Y [el error/estado que se ve en la plataforma]
THEN (comportamiento):
[acción concreta]
Ejemplo (evidencia):
[clínica], paciente/check [ID]
Rules
- Insurance = Trading Partner ID, always. The TPID is the same across all clinics; display names are not. Name goes in parentheses for readability only. If the TPID is unknown, ask the user — never guess or substitute the name.
- Condition = observed error/state, exactly as seen in the platform UI (e.g., "el check automático da failed", "la insurance tiene más de un copay").
- THEN = one concrete action the platform should take (retry with X, choose Y, allow Z).
- Evidence required: clinic + patient ID or check ID. If missing, ask for it.
- Feature requests state the behavior, never a question or timeline ask: "Cuando los usuarios crean un Prior Auth, permitir agregar modifiers a los CPT codes."
- Language: match the user's draft language (team usually writes Spanish); keep
WHEN/THEN keywords as-is.
- Output as plain copy-paste-ready text — no markdown formatting in the message itself.
Example: Before → After
Raw feedback:
"if MCO fails, run with straight Medicaid. Blossom: 10e9137f-2b13-4741-9372-528be4e7f6bc"
Formatted:
WHEN (condición):
Insurance = 68049 (Peach State Health Plan)
Y el check automático da failed
THEN (comportamiento):
Reintentar el check con Insurance = QBZJV
Ejemplo (evidencia):
Blossom, paciente 10e9137f-2b13-4741-9372-528be4e7f6bc
Example: Non-Insurance Rule (Copays)
WHEN (condición):
La insurance tiene más de un copay
THEN (comportamiento):
Elegir el copay cuyo mensaje contenga "freestanding"
Ejemplo (evidencia):
POM MRI, check 5586d696-7063-4581-b379-c04b953edb7d
Known Trading Partner IDs
| Payer |
TPID |
Notes |
| Peach State Health Plan (GA Medicaid MCO) |
68049 |
On failed check → retry with QBZJV |
| Georgia straight Medicaid |
QBZJV |
Fallback payer for 68049 |
Add new mappings here as they come up.
Common Mistakes
| Mistake |
Fix |
| Insurance referenced by name only |
Always TPID; name in parentheses |
| Condition written as assumed cause ("if MCO fails") |
Condition = visible error ("el check da failed") |
| Root-cause essay or pushback instead of the rule |
Template block + at most one Nota: line |
| Feature request as a question or timeline ask |
State the behavior: "Cuando [acción], [comportamiento]" |
| No evidence |
Clinic + patient/check ID, always |
1---2name: team-feedback3description: Format feedback for the Solum platform team — new rules (eligibility, insurance, copay), bug reports, and feature requests — using the WHEN/THEN/Example framework with Trading Partner IDs. Use this skill when the user wants to send feedback to the team or eng, report a platform bug, request a rule change, write a feature request, or convert raw clinic feedback into implementable rules. Triggers: "feedback for the team", "write this up for eng", "report this to the team", "new rule for the platform", "feature request", "convert this into a rule", "regla para la plataforma", or when the user pastes raw clinic feedback about eligibility, insurance, or copay behavior that needs to go to engineering.4---56# Team Feedback — WHEN/THEN/Example Framework78## Overview910Feedback to the platform team must be implementable without a single clarifying question: explicit condition + explicit behavior + evidence.1112**Core principle: write the condition as the error you SEE, never the cause you assume.** "If MCO fails" forces eng to investigate what an MCO is; "el check automático da failed" does not.1314## When to Use1516- New platform rules (eligibility, insurance, copay behavior)17- Bug reports18- Feature requests19- NOT for: strategy discussions, prose emails, customer-facing messages2021## The Output Contract2223The message consists of, in order:241. One template block per rule (below)252. Optionally, ONE line starting with `Nota:` flagging a concern for eng to consider2627Nothing else. No intro paragraphs, no root-cause analysis, no recommendations to "investigate first" — the rule as observed is the deliverable; a concern is one `Nota:` line.2829```30WHEN (condición):31Insurance = [Trading Partner ID] ([nombre])32Y [el error/estado que se ve en la plataforma]3334THEN (comportamiento):35[acción concreta]3637Ejemplo (evidencia):38[clínica], paciente/check [ID]39```4041## Rules42431. **Insurance = Trading Partner ID, always.** The TPID is the same across all clinics; display names are not. Name goes in parentheses for readability only. If the TPID is unknown, ask the user — never guess or substitute the name.442. **Condition = observed error/state**, exactly as seen in the platform UI (e.g., "el check automático da failed", "la insurance tiene más de un copay").453. **THEN = one concrete action** the platform should take (retry with X, choose Y, allow Z).464. **Evidence required:** clinic + patient ID or check ID. If missing, ask for it.475. **Feature requests state the behavior**, never a question or timeline ask: "Cuando los usuarios crean un Prior Auth, permitir agregar modifiers a los CPT codes."486. **Language:** match the user's draft language (team usually writes Spanish); keep `WHEN`/`THEN` keywords as-is.497. **Output as plain copy-paste-ready text** — no markdown formatting in the message itself.5051## Example: Before → After5253Raw feedback:54> "if MCO fails, run with straight Medicaid. Blossom: 10e9137f-2b13-4741-9372-528be4e7f6bc"5556Formatted:57```58WHEN (condición):59Insurance = 68049 (Peach State Health Plan)60Y el check automático da failed6162THEN (comportamiento):63Reintentar el check con Insurance = QBZJV6465Ejemplo (evidencia):66Blossom, paciente 10e9137f-2b13-4741-9372-528be4e7f6bc67```6869## Example: Non-Insurance Rule (Copays)7071```72WHEN (condición):73La insurance tiene más de un copay7475THEN (comportamiento):76Elegir el copay cuyo mensaje contenga "freestanding"7778Ejemplo (evidencia):79POM MRI, check 5586d696-7063-4581-b379-c04b953edb7d80```8182## Known Trading Partner IDs8384| Payer | TPID | Notes |85|-------|------|-------|86| Peach State Health Plan (GA Medicaid MCO) | 68049 | On failed check → retry with QBZJV |87| Georgia straight Medicaid | QBZJV | Fallback payer for 68049 |8889Add new mappings here as they come up.9091## Common Mistakes9293| Mistake | Fix |94|---------|-----|95| Insurance referenced by name only | Always TPID; name in parentheses |96| Condition written as assumed cause ("if MCO fails") | Condition = visible error ("el check da failed") |97| Root-cause essay or pushback instead of the rule | Template block + at most one `Nota:` line |98| Feature request as a question or timeline ask | State the behavior: "Cuando [acción], [comportamiento]" |99| No evidence | Clinic + patient/check ID, always |
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