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RNASEL04 - IS-H: Case Selection Singapore

RNASEL04 - IS-H: Case Selection Singapore

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Description

The report 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.

Requirements

Features

Selection

Specify the institution and a unique 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 adds further cases to this existing case selection.

As standard, the report does not select cases that have been final billed or have the status "Waiting List".

Similarly, the report does not select cases for which a Billing Block is set. If, however, you wish to include these cases in the selection, select + Cases with Billing Block. 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:

  • Searching for double-barreled names is not supported 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 specify only the first component of a patient's double name as the search term, 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 of the name, always terminate the search string with an *.

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 must exist for the case under Diagnosis Check in the Customizing activity Set Parameters for Diagnosis Documentation. 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 only want to select discharged cases, you can further restrict the selection set by specifying the discharge type. You can only use the Discharge Type parameter in combination with the discharge date.

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

Please bear in mind the following:

  • If you restrict your case selection according to 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, the report only uses admission, transfer, and discharge as last movements. It does not take outpatient visits and absences 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 the interval specified 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, choose Test Mode. The report then displays a list of all the cases that match your selection criteria. However, the report does not store the data in the tables relevant for billing and consequently this data is not available to the billing program.

You can use any combination of the selection criteria. For example, you can select only cases to which the following applies:

  • 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 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.
  • If you exclude one or more insurance providers, the report selects all the cases that do not have an insurance relationship with the specified insurance provider.
  • If you exclude one or more insurance provider types, the report selects all the cases that have at least one insurance relationship with an specified insurance provider that belongs to a different insurance provider type.

You can specify single values or intervals as selection criteria.

If you specify a case number, the report 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 Self-Payer Contribution are mutually exclusive. You can either search for specific insurance providers/groups or for specific self-payer contributions. The report then selects all the cases that have a case-related insurance relationship with the specified insurance provider or a self-payer insurance relationship.

Logging

You can choose between the logging types Cases and Movements. If you select the log Cases, the report only logs the selected cases.

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

For example, if you restrict your selection according to the admission date, the report 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 report does not currently display log the selected cases for technical reasons.

Example






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