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RNASEL00 - IS-H: Case Selection

RNASEL00 - IS-H: Case Selection

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Description

Report RNASEL00 selects cases for billing, and makes these cases available in tables.

You can use the selected cases for billing purposes by specifying a unique name for the case selection.

Selection Parameters

Specify an institution and a name for the case selection. You'll find your selected cases under this name later on. If you specify an existing case selection, the report appends additional cases to the existing case selection.

According to the standard settings, the report does not select cases that have the status Final Billed and Waiting List, but only cases with the status Not Billed or Partially Billed.

If you want to include final billed cases in the selection (for example, when canceling an invoice), you can control this using the parameter Billing Indicator Case.

The case also only selects cases with a billing block if you select the Cases with Billing Block indicator on the selection screen. Please note that in this case, the report also selects cases for which the process "Bill Case" is not allowed due to the status of medical documentation. The selection criterion Billing Block Reason allows you to restrict selection to cases for which the billing block has been set explicitly.

The value help for billing block reasons lists all the active billing block reasons - that is, all the billing block reasons you created in the Customizing activity below and for which you have not selected the "Inactive" indicator. However, you can also enter inactive block reasons manually in the Billing Block Reason field and the program will process them. For more information, see SAP Healthcare - Industry-Specific Components for Hospitals -> Patient Accounting -> Billing -> Define Billing Block Reasons in Customizing.

Notes on performance: Billing Block Reason is not a primary selection criterion. We therefore recommend that you combine it with other (primary) selection criteria, such as Case, Patient, Admission Date, Discharge Date, or Billing Indicator Case.

Please note the following when searching by patient names:

  • The system does not support searches for double-barreled names in case selection, since if these patients were assigned alphabetically to different users, they would appear in several selections.
    Example: Patient name Lawson-Barnett
    Search term L* -> patient is found
    Search term B* -> patient is not found
    If the double name search were supported, both the search terms L* and B* would result in the patient being found.
  • If you only enter the first part of the patient’s double-barreled name as the search string, the system does not find the patient.
    Example: Patient name Lawson-Barnett
    Search term Lawson -> patient is not found
    Search term Barnett -> patient is not found
    Search term Lawson* -> patient is found

If you are unsure with regard to naming, you should always enter a '*' at the end of the search term.

You can also restrict case selection to cases for which a particular diagnosis class exists. To do this, select Diagnosis Required. You specify which diagnosis is required for the case in Customizing for SAP Patient Management (IS-H) under SAP Healthcare - Industry-Specific Components for Hospitals -> Medical/Nursing Documentation -> Set Parameters for Diagnosis Documentation -> Diagnosis Check. You can choose the discharge diagnosis and/or the hospital main diagnosis.

The restriction with regard to the discharge diagnosis does not apply to patients who are companions.

If you selec the All Req. Confirmed indicator, this restricts the selection to cases whose insurance verification items all have the status "Confirmed". If you want to select all the cases that have at least one insurance verification item with the status "Confirmed", select the Part. Conf. (partial confirmation) indicator.

If you specify an insurance provider or insurance provider type in addition to a partial confirmation, there must be an insurance verification with the status Confirmed for the insurance provider or the insurance provider with the specified insurance provider type.

If you only want to select discharged cases, you can further restrict the selection set by specifying the discharge type. The report then only selects discharged cases that do not belong to the specified discharge type. You can only use the discharge type in combination with the discharge date.

You can further restrict the case selection using the Departmental Organizational Unit and Nursing Organizational Unit parameters.

Please note:

  • If you restrict your case selection by the discharge date of the case, the system checks the departmental/nursing organizational unit assigned to the case at the time of discharge against the departmental/nursing OU you specify here.
  • If you do not enter a discharge date in the case selection, the report checks the last movement for each case against the departmental/nursing organizational unit you specify here.
However, only admissions, transfers, and discharges can be last movements. Outpatient visits and absences are not taken into account.

Example:

You specify the departmental organizational unit "CU1" and the discharge interval "01/01/2010 - 04/01/2010".

The report selects all of the cases that were discharged in this interval and for which the care unit "CU1" is assigned as the departmental organizational unit at the time of discharge. The same applies to the nursing organizational unit.

If you do not want to make changes to the database, specify Test Mode as the processing mode. In test mode, the system lists all the cases that match your selection criteria. However, it does not store the data in the corresponding billing-relevant tables. No changes are made to the database.

Selection Criteria

The data selected by the report depends on the parameters you specify on execution. All the selection criteria can be combined.

You can only select the following cases:

  • Cases belonging to a particular institution
  • Cases with a particular case type
  • Cases for one patient
  • Cases for patients from a particular name group
  • Cases whose admission or discharge date is within a specified interval
  • Cases with a specific status of basic medical documentation
  • Cases for which a specific case classification (classification category, type) exists during the patient's stay
  • Cases that are assigned a specific insurance relationship (insurance provider)
If you specify insurance providers and an insurance provider type, the program selects all the cases that are assigned to the specified insurance provider in the insurance relationship and that have an insurance relationship with an insurance provider that belongs to the specified insurance provider type.

You can specify single values or intervals as selection criteria. For example, if you specify a case number, the system selects this one case.

In addition, you can specify whether the specified selection criteria are to be included or excluded.

The selection criteria Insurance Provider and Only Self-Payer Contribs are mutually exclusive.

You can either search for specific insurance providers/groups or for specific self-payer contributions.

Companions

The report provides a number of selection options relating to companions. You have the following four basic options:

  • All Cases
If you specify this criterion, the system selects all cases, regardless of whether they have a companion, are a companion, or have no companion.
  • Cases Without Companions
If you choose this option, the system selects all cases that are not accompanied - in other words, cases that are not assigned a companion. This includes cases admitted as companions for other cases, since these are not accompanied but serve as companions. To exclude these cases, select Exclude Companions.
  • Only Companions
If you choose this option, the system selects all the companions' cases. You can make a distinction between companions required for medical reasons and those that are not.
  • Accompanied Cases Only
If you choose this option, the system selects all the cases that are accompanied but not their companions. You can distinguish between a companion who is required for medical reasons and one who is not, but you cannot include the companions in the selection.

Logging

Three kinds of log are possible.
At present, only the logging types Cases and Movements are active. If you select the Cases log, the system only logs the selected cases.

If you select the log type Movements, the system only logs certain movements, depending on other selection parameters.

If you restrict your selection according to the admission date, for example, the system only logs the admission movement. If you restrict selection by the discharge date, the log only lists the discharge.

Billing Activities

You can start billing immediately after selection, and you can bill specifically using a variant.

If you start billing directly after selection, the cases that are selected are not logged.

Example






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