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RNAABW00 - IS-H: Adjust Services for Absence

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Description

This program performs a service adjustment for the selected cases in accordance with the absence of a patient.

Patient absences are entered as movements (start and end of absence) and do not delimit services when they are entered. This is performed by this program which cancels, delimits or creates new services, if necessary.

The following adjustments can be made:

• The service is entirely within the period of absence

• The service is cancelled.
  

• The absence period is entirely within the service period and the service start and end dates are after the absence start and end dates

• The service is delimited with the start date of the absence and a new service is created from the absence end date
  

• The service start date is before the absence period and the end date is during the absence period

• The end of the service is delimited with the start of the absence.
  

• The service end date is after the absence period and the start date is during the absence period

• The start of the service is delimited with the end date of the absence.
  

Selection must be carried out according to the discharge date, caes number, or selection indicator. In addition, you can limit your selection via the movement type of the absence start date and by certain services.

Using the chapter entitled Set Parameters for Handling Absences, you can define whether the absence start or end day is to be billed for.

In this table, you can also define the minimum duration of absence for the absence movements that are to be taken into account by the system. The duration of absence refers to full days of absence (that is, 24 hours).

By specifying an absence service, you can generate a new service for the absence period. This period of absence, in turn, is dependent on the parameters used to bill the absence start and end days. This enables the basic charge of an assigned bed to be billed with a reduced nursing charge, if necessary.

The minimum duration of absence and the absence service are proposed from the settings table and can be overwritten before this program is executed.

A test mode is also available.

Requirements

• Only inpatient and day patient cases are taken into account. If you define your selection according to discharge dates, only discharged cases are taken into account. If you enter case numbers in the selection box, the specified cases are taken into account, even if they have not been discharged yet.

• Services that have been billed in the interim are taken into account if the absence start date is after the last interim billing date of the service.

• Planned movements are only taken into account, if the status of the absence start date is not planned. A planned absence end date is processed in the same way as a patient who has not returned (end date 12/31/9999).

• Only extended services with the indicator absence-relevant are adjusted, irrespective of whether they are flagged as billable or non-billable.

• A minimum duration of absence of 0 days is only meaningful if the absence start and/or end date is not billed.

• Note that the absence service is also generated if no other service adjustment is performed for the absence in question. This prevents the absence service from being generated more than once for the same absence period.

Output

A log is output for all of the selected cases with a relevant absence movement and contains the absence-relevant extended services with their start and end dates before and after adjustment as well as a list of absence movements. Absence-relevant services that have been changed, cancelled, created, or left unchanged are also indicated. You can also restrict the log to include only services that have changed.

An extended log provides an explanation of why certain cases were not adjusted (for example, if the minimum duration of absence was not reached).

Example

• Absence start date: 01/14/96 (24:00)

• Absence end date: 01/07/96

• Service start date: 01/01/96

• Service end date: 01/20/96

• Absence start date indicator set (not billed)

• Absence end date indicator not set (billed)
  

• Adjust exist. services: 01/01/96 - 01/13/96 (24:00) and 01/17/96 - 01/20/96

• Create absence service: 01/14/96 (00:00) to 01/16/96 (24:00)

Further notes

Every day with a period of absence of 24 hours is regarded as a day of absence. If a period of absence starts at 00:00 and has not ended by 24:00, this day is regarded as a full day of absence, irrespective of whether the absence start date is billed or not. Similarly, an absence end date is always regarded as a full day of absence if it ends at 24:00and started at 00:00.

Note that, if the absence starts at 24:00, this day is regarded as a day of absence. The parameters that define how the absence start date is billed determine whether this day is billed or not. Absence end days that end at 00:00 are also processed in the same way. This day is regarded as an absence end day and is billed in accordance with the defined billing control parameters.

Planned absences are not taken into account by the system. If you have entered an absence start date with the status 'Actual' but the absence end date with the status 'Planned', the system does not adjust the service until you change the status of the absence end date to 'Actual'.

• If you shorten a period of absence after the service was adjusted for the original period, the system cannot extend the extended service to the new absence start or end date. By activating the rule type R5 in the check schema, you can output messages regarding charge gaps in departmental per diems and base nursing charges for the defined check periods. Messages cannot be generated for personal items, since there are no unique rules to govern how these items are contained in the case. In this case, the personal items must be adjusted manually. The absence service, if present, is adjusted to the modified period. If the absence period contains several absence services that require adjustment, the system cancels these services and creates a new absence service for the period in question.

• If you have cancelled a period of absence after a service adjustment has taken place, the system generates the services for the cancelled absence period under certain conditions. In doing so, it checks whether absence-relevant extended services end on the absence start date and start again at the absence end date. If these services were also generated by the actions contained in the rule type R9 or by the program RNAABW00, the system extends these actions to cover the period of the cancelled absence. The absence service, if present, is cancelled if it is no longer within an absence period.

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This documentation is copyright by SAP AG.

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